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Enrollment Processor/Customer Rep
2 months ago
We have Contract role for Enrollment Processor/Customer Rep for our client Danville, PA. Please let me know if you or any of your friends would be interested in this position.
Position Details:
Enrollment Processor/Customer Rep - Danville, PA
Location : Danville, PA 17822
Project Duration : 3+Months
Pay rate : $15/hr.
Job Summary:
Assists in resolving customer concerns, providing appropriate education/instruction and maintaining customer satisfaction by providing the highest level of customer service in only one of the Primary Functions (enrollment, claims or phones). Actively participates in cross training, improving processes within the Customer Service team.
Job Duties:
- Resolves and reconciles enrollment reports and all related eligibility issues by following policy and procedure as well as any state legislated coverage and eligibility guidelines.
- Initiates communication and literature to the newly enrolled Health Plan member, dependents and employer groups.
- Interprets and appropriately applies rules and regulations in contractual agreements and with employer groups and vendors.
- Performs membership data extract reports and supplies them to employer groups as an audit tool for accuracy and compliance with performance risk guarantee commitments.
- Updates, approves and interprets membership data and workflow produced by online software capabilities in employer group modules.
- Determines the eligibility of most members as well as processing terminations and dis enrollments.
- Prepares, generates and appropriately disseminates letter communications to subscribers and members with regard to enrollment activity.
- Determines if services received are covered benefits as applicable by line of business and product design.
- Reviews suspended claims for resolution by applying current policies, procedures and benefits applicable to specific products.
- Provides team building resources to assist in directing peers to proper claims resolution policies and procedures in order to assist members and providers.
- Provides daily support and advice to member and provider services staff regarding claims issues.
- Researches claim issues from participating providers and identifies specific criteria for reconsideration for payment.
- Work is typically performed in an office environment.
- Accountable for satisfying all job specific obligations and complying with all organization policies and procedures.
- The specific statements in this profile are not intended to be all-inclusive.
- They represent typical elements considered necessary to successfully perform the job.
Position Details:
- High School Diploma or Equivalent (GED)- (Required)
- Minimum of 1 year-Customer Service (Required)
Skills:
- OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Client family and our communities. KINDNESS: We strive to treat everyone as we would hope to be treated ourselves.
- EXCELLENCE: We treasure colleagues who humbly strive for excellence.
- LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow.
- INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation.
- SAFETY: We provide a safe environment for our patients and members and the Client family
About Generis Tek: generis tek is a boutique it/professional staffing based in Chicagoland. we offer both contingent labor & permanent placement services to several fortune 500 clients nationwide. Our philosophy is based on delivering long-term value and build lasting relationships with our clients, consultants and employees. Our fundamental success lies in understanding our clients’ specific needs and working very closely with our consultants to create a right fit for both sides. we aspire to be our client’s most trusted business partner.
