Enrollment Specialist

Group Health Cooperative of South Central Wisconsin•Madison, WI

23h

About The Position

Under the general supervision and direction of the Enrollment Supervisor, the Enrollment Specialist is responsible for accurately and promptly processing and maintaining membership and employer data for GHC-SCW members and group accounts, including those related to Medicare and Medicaid. This role also involves participating in premium billing processes and handling a high volume of inquiries from employer groups, members, and providers concerning eligibility status. GHC-SCW is a quality driven cooperative built on collaboration, community involvement, innovation, and belonging. In dedication to the health and well-being of our employees, we offer a comprehensive benefits package that includes health and dental insurance, along with paid short-term disability, long-term disability, and life insurance. Additional benefits include a flexible spending account, employee assistance programs, tuition reimbursement, pet insurance, eyewear discounts, and more. Check us out by clicking on Many Talents, One Mission! The Benefits of Working at GHC-SCW.

Requirements

High school graduate or equivalent is required.
A minimum of one (1) year of administrative office experience is required.
Extensive knowledge of and /or ability to learn Medicare, Medicaid, Federal and State enrollment regulations required.
Knowledge of and /or ability to learn procedures and practices related to HMO, medical services billing and enrollment, and knowledge of and /or ability to learn insurance enrollment software such as EPIC is required.
Knowledge of computers including ability to use various software packages such as MS Office Suite, email, and scheduling is required.
Ability to prioritize workload during heavy workload periods is required.
Ability to communicate effectively orally and in writing is required.
Ability to maintain patient confidentiality required.
Knowledge of or ability to learn HIPAA requirements.
Excellent customer service skills and the ability to work with diverse populations are required, including strong listening skills both on the telephone and in person.
Ability to work independently is required.
Ability to file numerically and alphabetically is required.
Ability to analyze, write, plan, explain and investigate is required.
Ability to use a keyboard extensively is required, including the ability to accurately type 40 w.p.m.
Ability to sit extensively, stand, kneel, and lift intermittently is required.
Ability to lift a minimum of 25 pounds is required.
Visual acuity is required.
Ability to work irregular hours and overtime when needed is required.
Ability to work harmoniously and cooperatively with all personnel and the public is required.

Nice To Haves

Experience in enrollment, billing or in an insurance or HMO related environment is preferred.
Experience in the operation of a PC, and 10-key adding machine is preferred.

Responsibilities

Accurately and promptly processing and maintaining membership and employer data for GHC-SCW members and group accounts, including those related to Medicare and Medicaid.
Participating in premium billing processes.
Handling a high volume of inquiries from employer groups, members, and providers concerning eligibility status.
Abiding by all Group Health Cooperative of South Central Wisconsin (GHC-SCW) organizational and departmental policies.
Setting personal standards and striving for high quality work in completing assignments.
Performing job duties in a timely manner.
Representing the organization in a positive manner.
Promoting the organization's Mission, Vision, and Common Values in behavior and attitude.