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Health Plan Specialist
4 weeks ago
Key Responsibilities:
- Database Management:
- Enter, scan, and update database information for new enrollments and terminations of health insurance products.
- Member Support:
- Handle enrollment or eligibility inquiries, including processing ID card requests and reprinting correspondence.
- Review pending enrollments for accuracy, analyze discrepancies, and reconcile records.
- Process Improvement:
- Identify performance gaps and recommend improvements to enrollment processes.
- Respond to correspondence promptly and effectively.
- Stakeholder Support:
- Communicate with stakeholders (e.g., brokers, customers, vendors) to obtain information and clarify concerns.
- Review enrollment submissions to identify missing or unclear data.
- Data Management:
- Review test or new eligibility electronic files to ensure accuracy.
- Compliance and Privacy:
- Adhere to audit controls, production standards, and regulatory requirements.
- Maintain confidentiality of patient protected health information (PHI).
- Collaboration:
- Partner with internal and external stakeholders to address errors or concerns with enrollment data.
- Work with cross-functional teams to ensure readiness for enrollments.
**Education**:
- High School Diploma or equivalent experience.
**Experience**:
- Minimum of 1 year recent relevant experience.
Skills and Knowledge:
- General knowledge of health care operations and structure.
- Familiarity with health insurance concepts and regulations.
- Attention to detail and organizational skills.
- Proficiency in Microsoft Office Suite and database management.
- Ability to work independently and collaboratively in a fast-paced environment
**Job Types**: Contract, Temporary
Pay: $21.00 - $22.00 per hour
Expected hours: 40 per week
Healthcare setting:
- Acute care
- Children's hospital
- Clinic
- Hospital
- Inpatient
- Medical office
- Outpatient
- Private practice
- Rehabilitation center
- Telehealth
- Urgent care center
Medical specialties:
- Addiction Medicine
- Anesthesiology
- Cardiology
- Critical & Intensive Care
- Dermatology
- Gastroenterology
- Geriatrics
- Home Health
- Hospice & Palliative Medicine
- Hospital Medicine
- Internal Medicine
- Medical-Surgical
- Neurology
- Ob/Gyn
- Occupational Medicine
- Oncology
- Orthopedics
- Pain Medicine
- Pathology
- Pediatrics
- Perioperative Care
- Podiatry
- Primary Care
- Psychiatry
- Radiology
- Surgery
- Telemetry
- Urgent Care
- Wound Care
Schedule:
- 8 hour shift
- Day shift
- Monday to Friday
Work Location: In person
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