DescriptionPrimary Job Purpose
The Enrollment Specialist establishes and maintains eligibility and provides eligibility related customer service to accounts of varying complexity and maintenance.
Competencies and Knowledge:
- Demonstrated proficiency on 10 key.
- Demonstrated 40 wpm tying skills with 95% accuracy
- Ability to express ideas and recommendations clearly and with a high level of professionalism in written and oral communications.
- Proficiency with Microsoft Office software.
- Ability to work in an Imaging environment.
- Ability to work in a web based environment.
- Ability to think analytically and to make sound judgments from analysis.
- Ability to plan and organize own work.
- Ability to work flexible hours during periods of heavy workloads.
- Ability to exercise judgment, initiative and discretion in confidential, mature and sensitive manner.
Normally to be proficient in the competencies listed above:
Enrollment Specialist I LifeMap would have a High School Diploma or GED and related work experience.
Relevant work experience in ancillary lines of insurance (e.g. group life and benefits / disability) is a plus.
General Functions and Outcomes:
- Communicates and coordinate with all stakeholders (customers, 3rd party, LifeMap cross-functional support team) to answer questions and help facilitate end to end onboarding experience, this includes discrepancy and billing research, acquiring information necessary to update the system or process fallout transactions and provide timely and accurate feedback to all associated parties.
- Will handle a variety of different enrollment matters and related tasks with Electronic Enrollment Department. May be assigned to more complex accounts.
- Activate, review, reconcile, and maintain individual, small, large or specialized group enrollment applications. Calculate appropriate waiting period credits, eligibility data, effective date and enter member data as appropriate to calculate premiums. Information needed to maintain these accounts can come from telephone calls to or from employers, insured members, or agents, or incoming mail or fax.
- Review benefit set up to ensure that the billing is correct. Monitor guarantee-issue rules and notify Medical Underwriting to communicate with insured members when EOI is required.
- Provide customer service to internal and external customers by supplying information through written correspondence and responding to telephone inquiries.
- Incorporate and apply changes made to LifeMap enrollment policies and procedures to ensure current requirements are met.
- Ensure changes are processed through defined daily metrics to achieve established enrollment turnaround standards. Enrollment is done using mainframe, Web and Imaging systems.
- Perform accurately and timely all eligibility tasks and assist and train less experienced staff in interpreting benefits and eligibility.
- Sets up the new customer project task and leads the customer, broker, and trading partner through the onboarding process for EDI and/or any other LifeMap internal systems including providing regular updates and next steps.
- Adds New and amended groups to the upload list for addition or re-cede to the EAC database.
- Process User Invitations, Terminations, Disable and Enable functions and unlock accounts when necessary.
- Test primary functions for new groups on the EAC and work with teams to correct any issues.
- May assist in system testing as needed.
- In support of other staff, will cross-train on a variety of jobs to provide back-up capabilities including back-up for other LifeMap Departments.
Remote position at this time due to the COVID-19
Email your resume to our team today for immediate consideration!
Job RequirementsEducation Required: High School
Experience Required: Entry Level
Last updated on 04/08/2020
16.00 - 18.00
Are you interested in this position? Please complete our On-Line Application. Please note that your application will remain on file for 90 days for consideration for any of our open positions that match your qualifications.
If you have completed our on-line application in the last 90 days you can send a letter of interest to the recruiter hiring for this position at firstname.lastname@example.org. Please include a copy of your resume with your email or application.
Personnel Source, Inc. is an equal opportunity employer.