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Job Summary

The Membership Enrollment Specialist I processes enrollment additions, updates, changes, reinstatements, and terminations in an accurate and timely manner for the assigned product line. The incumbent is responsible for processing of renewals and premium billing. The incumbent works closely and directly interacts with external customers such as employer groups, 834 vendors and brokers/consultants, and with internal customers such as Underwriting, Account Management, Sales, Customer Service staff, Claims staff, etc. to answer questions and resolve issues.

Requirements

EDUCATION

High School diploma or equivalent.

EXPERIENCE

Minimum two (2) years' college coursework (48 semester hours) or other equivalent certification with an emphasis in general business, health plan administration, or medical-related fields of study OR minimum of one (1) year of relevant office work experience (such as claims administration, medical office, health insurance, etc.).

ESSENTIAL SKILLS & ABILITIES

Strong time management and organizational skills

Results-driven with highly developed attention to detail

Primary focus on accuracy and outcomes

Customer service

Strong interpersonal skills

Keyboarding

Dependability

High integrity

Confidentiality

Problem solving

Issue resolution

Sound judgment

Computer literacy

Microsoft Office

Oral and written communication

Teamwork

Skills

• Active Listening
• Administrative Review
• Conflict Resolution
• Critical Thinking
• Customer Service
• Decision Making
• External Collaboration
• Interpersonal Communication
• Microsoft Office
• Oral Communications
• Organizing
• Performing Administrative Activities
• Problem Sensitivity
• Researching
• Results Interpretation
• Time Management
• Written Communication

Responsibilities

• Accepts, investigates, and responds to incoming calls, e-mails, and other forms of communication in an accurate, timely and professional manner.
• Assists with employer groups, 834 vendors, brokers/consultants, Customer Service, Claims, Account Management and/or Sales staff needs, as required.
• Confirms information including but not limited to: enrollment/membership status, records, questions or concerns, and database requests.
• Drives and supports high-work-volume aOpen Enrollment activities each year.
• Generates and distributes membership-related documents such as ID cards, Certificates of Coverage, Certificates of Creditable Coverage, etc.
• Maintains ongoing correspondence with internal and external customers.
• Performs other duties as assigned.
• Processes enrollment additions, changes, reinstatements, and cancellations in an accurate and timely manner.
• Provides clerical and technical support for enrolling members, membership vendors, brokers and consultants, and employer groups.
• Provides excellent customer service and guidance to both internal and external customers.
• Responsible and accountable for up-to-date knowledge and achievement of divisional standards related to production, quality, and dependability.

Certifications

Security Requirements

This position is identified as level three (3). This position must ensure the security and confidentiality of records and information to prevent substantial harm, embarrassment, inconvenience, or unfairness to any individual on whom information is maintained. The integrity of information must be maintained as outlined in the company Administrative Manual.

Segregation of Duties

Segregation of duties will be used to ensure that errors or irregularities are prevented or detected on a timely basis by employees in the normal course of business. This position must adhere to the segregation of duties guidelines in the Administrative Manual.

Employment Type

Regular

ADA Requirements

1.1 General Office Worker, Sedentary, Campus Travel - Someone who normally works in an office setting or remotely and routinely travels for work within walking distance of location of primary work assignment.