Nexeo HR has teamed up with a leader in the health insurance industry in Utah! We are looking for an Enrollment Specialist. The ideal candidate will have accounting and customer service experience. This is a temp-to-hire position.
Essential Job Duties
• 1. Adheres to enrollment policies necessary for maintaining member eligibility records in specific systems.
• 2. Verifies member eligibility data received is in accordance with the contract.
• 3. Interacts with external sources to resolve incorrect or missing information required to enroll or make changes to a member's eligibility.
• 4. Upholds SelectHealth standards for defined service level agreements.
• 5. Complies with government regulations to meet or exceed audit process and protocols.
• 6. Maintains company phone standards while researching and resolving internal/external customer calls.
• 7. Works closely with other departments to ensure compliance with COBRA, HIPAA, Federal and State laws, and company policies and procedures.
• 8. Analyzes and resolves complex eligibility discrepancies resulting in the correct final result with the understanding of the financial impact.
• 9. Communicates verbally and in writing with internal and external customers.
• 10. Adapts to changing processes and environments.
• 11. Audits and reconciles multiple electronic eligibility transactions per member resulting in the correct final result with understanding of the financial impact.
• 12. Serves as a resource for level I team members as needed (backup, questions, mentor, training, etc).
• 13. Assists and provides feedback on testing of new applications or changes to existing system.
• 14. Supports the Enrollment team with system functionality issues by initiating changes as needed and facilitating problem resolution.
• 15. Serves an intricate role on committees representing the Enrollment department.
• 16. Runs and distributes eligibility audit queries.
****MUST HAVE MEDICARE EXPERIENCE***
- Associates Degree
- Data processing
- Details oriented
- Able to run SQL statements to review data Communication/Speak up/Respectful/Ask questions
- •Able to handle stress/adapts to constant change
- •Multi task •Analytical/Research in depth
- •Positive attitude
- •Team player/Work independently/self-motivated
Would need to work from home until further notice - will pick up equipment in person on first day. Candidate must be comfortable with training remotely
Schedule: Monday-Friday, 8 am - 5 pm
Pay Range: $18-$20
If you have any questions, please contact us!
Salt Lake City, UT