Enrollment Representative (44382)
About The Position
Under direct supervision, is responsible for a variety of specific functions associated with enrollment and reconciliation transactions to facilitate accurate enrollment data. The Enrollment Representative processes enrollment data within a timeframe and at a performance level that ensures members timely access to benefits and accurate processing of claims. This role will compile eligibility discrepancies in a timely manner to ensure that members are able to obtain health services appropriately. The Enrollment Representative also works collaboratively with various internal departments to resolve complex issues related to member eligibility and provider discrepancies to meet the Mission, Vision and Values of Neighborhood.
Requirements
- High School Degree or equivalent
- Three (3) years’ HMO/insurance experience in member service/enrollment
- Communication skills, including excellent writing abilities
- Intermediate skills in Microsoft Office (Word, Excel, Outlook)
- Organizational skills and reporting experience
- Ability to work independently and as a team player
- Strong attention to detail and problem solving skills
- Ability to handle multiple responsibilities simultaneously
- Ability to work cross-functionally across different departments within the organization
Responsibilities
- Maintain membership eligibility information in system
- Generate membership correspondence
- Produce enrollment activity reports for internal and external customers
- Interact with internal and external contacts regarding membership and eligibility issues
- Reporting and billing of births
- Manual data entry of newborns, exception reports and daily spreadsheets
- Provide enrollment information to internal customers about enrollment issues
- Act as secondary contact in communicating with EOHHS, HP, DCYF and/or HSRI to resolve enrollment issues
- Communicate to the Member Services department the status of enrollment processes
- Support and work collaboratively with the next level analysts in handling some tasks related to Coordination of Benefits, including research, outreach and reporting
- Provide back up to the next level analysts in a limited scope
- Maintaining absolute file integrity with regards to content, location and confidentiality
- Participate in training and development
- Identify opportunities for process improvements and workflow efficiencies
- Other duties as assigned
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
