About The Position

Responsible for performing enrollment and eligibility data entry, updates, maintenance, review, transaction processing, correspondence queueing or routing, issue escalation, and compliance-based enrollment processing in accordance with established guidelines, policies, procedures, and applicable requirements.

Requirements

  • Strong oral and written communication skills.
  • Self-motivated with the ability to handle multiple tasks and work with minimal supervision.
  • Strong organizational skills.
  • Ability to work effectively with personnel at various levels.
  • High attention to detail.
  • Successful completion of Health Care Sanctions background check.
  • Proficient in Microsoft office applications.

Nice To Haves

  • Two years working in an administrative function for a health care institution, insurance company or medical group.

Responsibilities

  • Enter, update, and maintain enrollment and eligibility data; confirm for accuracy.
  • Review enrollment information for completeness, accuracy, and compliance with established guidelines.
  • Process enrollment transactions, changes, updates, and corrections.
  • Maintain accurate member, group, and customer enrollment records through routine data maintenance.
  • Queue, route, or generate enrollment-related correspondence as required.
  • Identify incomplete, inconsistent, or missing enrollment information and escalate or route issues as needed.
  • Ensure enrollment processing activities comply with internal policies, procedures, and applicable regulatory requirements.
  • Perform other job-related duties as required or assigned.
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