- Demonstrate commitment and behavior aligned with the philosophy, mission, values and vision of Network Health
- Appropriately apply all organizational, regulatory, and credentialing principles, procedures, requirements, regulations, and policies
- Process enrollment applications, changes and terminations for all products received.
- Responsible for handling incoming and outgoing telephone calls regarding group and member inquiries as well as inquiries from Sales, Customer Service, Agent Support, Compliance, Social Services, Care Management, Finance, and other groups as needed.
- Assist in managing an organized a compliant member filing system. Responsible for maintaining and controlling access to member electronic files and assuring that they are kept in a complete and organized manner. Complete by-member submission for electronic filing on a daily basis.
- Create and maintain accurate and complete desk procedures for all tasks. Assures that procedures, documentation and communication are such that risk of legal action is minimized.
- Drafts written correspondence or requests appropriate system form letters.
- Review on a regular basis federal regulations, state mandates, legislative changes, and legal requirements for enrollment processing. Assure that policies and procedures, documentation, and communications are such that risk of legal action is minimized.
- Other duties as assigned.
- Strong oral and written communication skills with the ability to listen mindfully, identify gaps and ask appropriate questions
- Ability to organize one's work and space to ensure successful completion of assigned tasks within the identified timeframe
- Ability to adapt to new circumstances, information and challenges in a fast paced environment
- Ability to work independently, as well as part of a team
- Skills required include the ability to work independently and meet deadlines.
- Must possess an upbeat service-oriented attitude and be able to communicate and coordinate well with team members and external customers.
- Ability to work well under various stressful and time sensitive situations.
- Proficiency in MS Word, Excel, Outlook
- Must have high accuracy in data entry and review documents with sharp attention to detail. Ability to handle large volumes of data.
- Strong verbal, written, interpersonal, grammar, and proofreading skills. Understanding of the customer service process.
- High School Diploma. Associate Degree or equivalent experience preferred.
- Knowledge of and operational experience with health insurance preferred.
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Enrollment Specialist I - Brookfield, United States - Network Health
Description
Network Health's success is rooted in its mission to enhance the life, health and wellness of the people we serve. It drives the decisions we make, including the people we choose to join our growing team. Network Health is seeking an Enrollment Specialist. This individual is responsible for assisting with all enrollment, disenrollment, fulfillment, reconciliation and related activities for all of Network's products. This individual will work with internal and external stakeholders to ensure timely processing of all transactions and continued compliance with all state and federal regulations. Responsible for communicating (in writing or verbally) with group contacts, members, agents, brokerage firms, and internal sales staff for the purpose of providing quality customer service.
Essential Job Duties:
Knowledge/Skills/Abilities Required:
Minimum Education Required:
Minimum Related Years of Experience (per minimum education) Required:
Candidates must reside in the state of Wisconsin for consideration. This position is eligible to work at your home office (reliable internet is required), at our office in Brookfield or Menasha, or a combination of both in our hybrid workplace model.
Network Health is an Affirmative Action & Equal Opportunity Employer. We encourage applications from all backgrounds, communities and industries, and are committed to having a team that is made up of diverse skills, experiences and abilities. We are committed to equality and diversity within Network Health.
Network Health is a DiversityJobs Employer Member for our commitment to diversity in the workplace.
*WARNING: Please beware of phishing scams that promote work-at-home opportunities and which may also pose as legitimate companies. Please be advised that Network Health recruiter will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for a role with our company. All of our positions require that you first complete an online application.
