Note: Individuals typically begin between the minimum to middle of the pay range
To provide Best Customer Experience, Most Affordable Care, and Best Quality Care, by resolving enrollment, eligibility and billing issues and inquiries from members and employer groups accurately and timely. Ensure that all government, association and department guidelines, objectives and performance standards are met. Perform quality assurance audits and provide recommendations to improve customer satisfaction.
Minimum Qualifications
Associate's degree and one year of related work experience or equivalent combination of education and experience.
Effective verbal and written communication skills.
Requires attention to detail and the ability to work on multiple projects simultaneously.
Working knowledge of general office practices and procedures.
Basic knowledge of Microsoft Office applications. Including but not limited to Word, Excel, and Outlook.
Duties and Responsibilities
Resolve enrollment, eligibility and billing issues and inquiries timely and accurately from members, employer groups and third party administrators by phone, email and written correspondence by:
Researching and collaborating with other units or departments to find a solution
Accurately updating member records
Contacting external partners who provide services for/to HMSA's members
Providing member or group education on enrollment, billing (bill resentment) and bill payment
Support unit in performing enrollment and billing reconciliations activities for purpose of identifying discrepancies and initiating accurate and timely correction/resolution of internal as well as external processing systems.
Support unit in daily enrollment functions to include processing of enrollments, disenrollment's and maintenance for members.
Perform quality assurance audits of customer inquiries and member updates within constrained timeframes. Based on patterns or risk assessment, recommend improvement opportunities to provide processing efficiency and increase customer satisfaction. These can include but are not limited to identifying processing or servicing issues that can be addressed by a system or a workflow solution
Training and Development
Performs all other miscellaneous responsibilities and duties as assigned or directed.
Seniority level
Entry level
Employment type
Full-time
Job function
Legal
Industries
Insurance
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