Premium Billing and Enrollment Coordinator

Sanford Health • Marshfield, WI

3d • Onsite

About The Position

The Premium Billing and Enrollment Coordinator is responsible for the timely and accurate maintenance of enrollments and the billing processes in accordance with contracts, member certificates and regulatory entities. This role involves processing daily individual and business enrollments, ensuring timely and accurate entry and receipt of all required documentation. The coordinator will research and resolve billing variances to maintain system accuracy, handle customer inquiries, and provide detailed information on requirements. Additionally, the role includes managing daily ad hoc discrepancy reports, processing and mailing member letters, and performing other assigned duties. The position requires strong analytical and problem-solving skills, effective communication, and the ability to assimilate information to maintain a broad knowledge base. Maintaining confidentiality and positive professional relationships with internal staff, clients, members, and vendors is crucial.

Requirements

• Must be detail oriented with the ability to investigate and problem solve.
• Relies on experiences to recognize enrollment and eligibility discrepancies.
• Must be able to effectively communicate, verbally and written, with internal departments and clients/members regarding enrollment processes and procedures, eligibility inquires and verification of data.
• Demonstrates analytical ability in processing electronic enrollment files.
• Assimilates large amounts of information to maintain a broad knowledge base.
• Exercises good judgment in determining best methods of solving problems.
• Maintains a positive and professional relationship with internal staff, clients, members and vendors.
• Maintains confidentiality.
• Must have complete knowledge and skills with ability to be fully proficient in an administrative area, knowledge and understanding of different markets.
• Solid technical skills (Microsoft Office).
• Strong written and verbal communication skills.
• Strong drive for results and accountability.
• Ability to work in a team environment.
• Demonstrates attention to detail.
• Skilled in problem identification and resolution.
• Exceptional judgement and decision-making abilities.
• Maintains current billing processes and ensure accuracy of member's accounts.
• Provides exceptional customer service to clients promptly and accurately.
• Maintains confidentiality.
• High school diploma, or equivalent required.

Nice To Haves

• 2 years experience in health insurance or similar industry including enrollment and eligibility preferred.

Responsibilities

• Responsible for the daily process of the individual and business enrollments ensuring they are entered timely and accurately and that all required documentation is received.
• Research and resolve billing variances to maintain system accuracy.
• Handle questions, issues and provide detailed information on requirements to our internal and external customers.
• Responsible for billing processes in accordance with contracts, member certificates and regulatory entities.
• Responsible for daily ad hoc discrepancy reports.
• Process and mail letters to our members for various reasons.
• Perform other duties as assigned.

What This Job Offers

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