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Membership Representative Ii

3 months ago

Latham, United States Elevance Health Full time

Job Family: MBR > Membership & Enrollment Rep

Type:
Date Posted: Jun 03, 2024

Anticipated End Date: Jul 01, 2024

Reference: JR118749

Description

**Membership Representative II**

The **Membership Representative II **is responsible for enrollment, billing activities and/or maintaining assigned accounts. Must be able to successfully perform all the duties of the Membership Rep I.

**How you will make an impact**:

- Responds to incoming calls and may initiate outgoing calls, providing customer service to plan members, providers and employer groups by answering benefit questions, resolving issues and educating callers.
- Verifies enrollment status, makes changes to records, researches and resolves enrollment system rejections; addresses a variety of enrollment questions and/or concerns received by phone or mail.
- May be responsible for billing and delinquency processes for assigned groups.
- Ensures accuracy and timeliness of the membership and billing function.
- Responds to inquiries concerning enrollment processes.
- Maintains enrollment database.
- May order identification cards.
- Determines eligibility and applies contract language for each case assigned.
- Performs error output resolution for electronic eligibility and processes error discrepancy lists.
- Maintains and reconciles premium bill, self-bill and individual billed accounts.
- Notifies clients of premium discrepancies through payment adjustment notices and detailed audits.
- Screens all forms and data for all paperwork received from Sales and/or
- Underwriting for new group and/or group re-classing benefits.
- Makes request to Underwriting, Sales or Brokers for missing information and/or forms needed for new group or re-class of existing group.
- May be responsible for loading rates for new groups and renewal/re-class groups within the appropriate system.
- Screens group for benefits to determine if existing or new, recognizing when benefits are not standard and handling as appropriate.
- Thoroughly documents inquiry outcomes for accurate tracking and analysis.
- Develops and maintains positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner.

**Minimum Requirements**:

- Requires H.S. diploma or GED and a minimum of 1 year relevant healthcare customer servicing experience which includes a minimum of 1 year membership experience with the company; or any combination of education and experience which would provide an equivalent background.

**Preferred Skills, Capabilities & Experiences**:

- Experience working in healthcare highly preferred.
- Familiar with operating a PC. Experience with Microsoft Office products (Excel, Outlook, Word, Access, etc).
- Experience working with any of the following systems: CAS/Connect, FlexCare, ServiceConnect and/or CareConnect.

Location: New York;
- The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (u