Enrollment & Premium Billing - Hybrid

Fallon Health • Worcester, MA

395d

About The Position

The Enrollment & Billing Operations Representative III at Fallon Health plays a crucial role in supporting the organization's mission by ensuring accurate and timely enrollment and billing information. This position involves maintaining data integrity within the core system, collaborating with various departments, and adhering to regulatory compliance. The representative is responsible for addressing customer inquiries, reconciling billing reports, and assisting in process improvements, all while maintaining a positive approach to problem-solving.

Requirements

• High school diploma required; Bachelor's Degree preferred.
• 5 plus years' experience in an office environment, preferably in health care and/or managed care system.
• Strong analytical and problem-solving skills.
• Excellent organizational skills and time management.
• Strong focus on quality and performance results.
• Systems knowledge including MS Excel, MS Word, and MS Access.
• Ability to effectively communicate, both written and verbal.

Nice To Haves

• Experience in health care and/or managed care systems.
• Strong multitasking abilities.
• Ability to work in a fast-paced environment.

Responsibilities

• Provide knowledgeable responses to internal and external customer inquiries regarding enrollment and billing.
• Enter and maintain premium rates as provided by Actuarial and Regulatory Affairs.
• Reconcile membership and billing reports to ensure accuracy of information.
• Communicate professionally to resolve discrepancies in billing and enrollment.
• Maintain the accuracy and integrity of eligibility and premium tasks.
• Provide eligibility and premium support to the Sales department or Regulatory Affairs as needed.
• Collect premiums for employer groups and individual members, including written correspondence and collection calls.
• Prepare documented payment plans for customer requests and present them to Management for approval.
• Train new hires and existing staff as needed.
• Participate in departmental and company-wide process improvement projects.

Benefits

• Health insurance coverage
• 401k retirement savings plan
• Paid holidays
• Professional development opportunities
• Flexible scheduling

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Hospitals
• Education Level: High school or GED