Job Overview
The Entrollement Specialist is responsible for processing eligibility additions, modifications and terminations. This includes resolving all billing and accounts receivable issues. The candidate will also be responsible for applying Centers for Medicare and Medicaid Services (CMS) regulations and policies to each enrollment and disenrollment request. You will provide additional support as needed for all enrollment functions. Essential Job Functions:
- Reviews all incoming member and employer group materials; Determines and records appropriate identification number Verifies and/or updates demographic information as appropriate
- Determines enrollment periods, pre-existing condition expiration dates and creditable coverage
- Processes eligibility additions, modifications and terminations; Establishes appropriate billing method
- Works with member, employer group, agent and CMS to resolve any outstanding questions
- Reviews and approves enrollment reports prior to weekly transmission of eligibility files to CMS
- Analyzes and resolves billing and accounts receivable issues for members regarding premium payments and delinquent accounts Posts member premium payments; Audits and monitors monthly premium billings and collects on all delinquent accounts
- Documents all verbal and written contacts
- Regular attendance is required in order to carry out the essential functions of the position
- Reviews and meets ongoing competency requirements of the role to maintain the skills, knowledge and abilities to perform, within scope, role specific functions
- Other duties as assigned
Requirements
- For positions requiring education beyond a High School diploma or equivalent; Educational qualifications must be from an institution whose accreditation is recognized by the Council for Higher Education and Accreditation
- Minimum of one year of experience in office setting with basic administrative skills, including data entry, Microsoft Word and Microsoft Excel
- Intermediate level of Microsoft Word and Excel classes required, or must demonstrate equivalent expertise
- Excellent oral and written communication skills
Preferred/Optional:
- Additional college or technical school classes in business or insurance
Are you interested in this position?
Apply by clicking on the “Apply Now” button below!
#AlbionarcJobs#FintechJobs
#AsiaJobs#MiddleEastCareers
#TechTalent#FintechRecruitment
#FinanceOpportunities#
Quick Job application form
Employer : Aqua Digital Rising
