Health Plan Enrollment Representative
2 weeks ago
IDR is seeking a Health Plan Enrollment Representative to join one of our top healthcare clientsin Sacramento, California. If you are looking for an opportunity to join a large organization and work within an ever-growing team-oriented culture, please apply today
Position Overview for the Health Plan Enrollment Representative:
- Data Management and Enrollment Processing: Prepare, process, and maintain new member or group registration information in the enrollment database, ensuring accuracy and timely updates. This includes managing demographic changes, such as address and primary care provider updates, and handling duplicate ID card requests.
- Eligibility Verification and Discrepancy Resolution: Respond to member or group eligibility questions, verify enrollment status, reconcile discrepancies, and submit retroactive eligibility changes as needed. Ensure accurate and up-to-date member information is maintained in relevant systems.
- Stakeholder Communication: Liaise with stakeholders, including brokers, customers, and vendors, to clarify and resolve issues related to enrollment and eligibility. Ensure all necessary information is collected and discrepancies are addressed promptly.
- Compliance and Reporting: Adhere to all audit controls, production standards, and regulatory requirements, including maintaining the confidentiality of patient protected health information (PHI). Perform audits to validate enrollment and eligibility data and ensure compliance with relevant regulations.
- Educational Background: High School Diploma or General Education Diploma (GED) is required.
- Relevant Experience: At least 1 year of recent experience in a related role, demonstrating knowledge of health insurance concepts, enrollment practices, and eligibility verification.
- Technical Proficiency: Proficiency in Microsoft Office Suite, including Word, Excel, and PowerPoint. Familiarity with database management, data validation techniques, and relevant file layouts, such as Flexible Spending Accounts (FSA).
- Skills and Knowledge: Strong analytical, organizational, and time management skills. Ability to handle multiple tasks, prioritize effectively, and work both independently and as part of a team. Basic understanding of healthcare operations, managed care, and relevant regulations, particularly those set by the California Department of Managed Health Care (DMHC).
What's in it for you?
- Competitive compensation package
- Full Benefits; Medical, Vision, Dental, and more
- Opportunity to get in with an industry leading organization
- Close-knit and team-oriented culture
Why IDR?
- 25+ Years of Proven Industry Experience in 4 major markets
- Employee Stock Ownership Program
- Dedicated Engagement Manager who is committed to you and your success
- Medical, Dental, Vision, and Life Insurance
- ClearlyRated's Best of Staffing® Client and Talent Award winner 11 years in a row
Compensation Details:$24-$26.42/hr. W2. NOT OPEN TO C2C.
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