Nexeo HR is seeking rockstar Enrollment Coordinators to work in a healthcare setting! This position would be responsible for the creation and maintenance of Government and/or Commercial member eligibility records, providing phone support, resolve more complex eligibility discrepancies and questions.
- Adheres to enrollment policies necessary for maintaining member eligibility records in specific systems.
- Verifies member eligibility data received is in accordance with the contract.
- Interacts with external sources to resolve incorrect or missing information required to enroll or make changes to a member's eligibility.. Upholds company standards for defined service level agreements.
- Complies with government regulations to meet or exceed audit process and protocols.
- Maintains company phone standards while researching and resolving internal/external customer calls.
- Works closely with other departments to ensure compliance with COBRA, HIPAA, Federal and State laws, and company policies and procedures.
- Analyzes and resolves complex eligibility discrepancies resulting in the correct final result with the understanding of the financial impact.
- Communicates verbally and in writing with internal and external customers.
- Adapts to changing processes and environments.
- Audits and reconciles multiple electronic eligibility transactions per member resulting in the correct final result with understanding of the financial impact.
- Serves as a resource for level I team members as needed (backup, questions, mentor, training, etc).
- Assists and provides feedback on testing of new applications or changes to existing system.
- Supports the Enrollment team with system functionality issues by initiating changes as needed and facilitating problem resolution.
- Serves an intricate role on committees representing the Enrollment department.
- Runs and distributes eligibility audit queries.
• Function well in difficult situations including conflict resolution in a team environment.
• Proficient in Facets or similar eligibility system.
• Experience with Federal and State regulations which govern company policies and procedures.
• Intermediate knowledge of billing reconciliation processes.
• One to two years experience working with or tracking various pieces of eligibility information, benefit information, or employee data.
• Two to three years of customer service experience.
• Demonstrated data processing skills with ten key score of 100 spm and typing speed of 60 wpm.
• Demonstrated intermediate skills with spreadsheets, word processing, and databases.
• Demonstrated fundamental knowledge of billing and account receivable functions.