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Enrollment & Billing Specialist II
2 months ago
Job Description:
Enrollment & Billing Specialist II
from the Company
Blue Cross Blue Shield of Louisiana , located in
Baton Rouge, LA , United States.
Job Responsibility:
The Enrollment and Billing Specialist II must be able to perform the work of an E&B specialist I. Maintains and reconciles eligibility, delinquency, and reinstatement issues. Analyzes and processes transactions and reports. Processes member level refunds. Works cohesively in a team and shifts work tasks and priorities as needed.
NATURE AND SCOPE
This role does not manage people
This role reports to: SUPERVISOR, ENROLLMENT & BILLING
Necessary Contacts: In order to effectively fulfill this position, the incumbent must be in contact with Accounting, Actuarial, BET, Claims, Compliance, Customer Service, Finance, Legal, Sales and Marketing, Underwriting, IT, District Offices, Producers, Group Leaders, Brokers, 834 vendors, and all levels of Enrollment and Billing personnel and other BCBSLA departments as needed.
QUALIFICATIONS
Education
High School Diploma or equivalent is required
Associate's degree is preferred
Work Experience
2 years of Enrollment and Billing experience is required
1 year of operational, marketing, and/or customer service experience is preferred
Skills and Abilities
Must understand insurance and have a working knowledge of enrollment and billing functions and FACETS system.
Must have strong organizational and analytical abilities and effective interpersonal skills.
Must have the ability to research, analyze, and resolve enrollment and billing issues.
Must have a working knowledge of relevant software (MS Word, Excel, Outlook, etc.) and related software as other corporate programs and applications, including but not limited to SMA (preferred), Common Query, CMOD, and Benefit Focus.
Must have a working knowledge to apply company policies and procedures, company guidelines, state and federal laws and mandates (e.g., HIPPA, COBRA, PPACA, etc.) to ensure information is current and accurate.
Must demonstrate verbal and communication skills with the ability to interpret and communicate information with tact, diplomacy, patience, and professionalism.
Must be able to make quick, appropriate decisions that lead to both internal and external customer satisfaction with minimal supervision, learn quickly, multitask, prioritize work to meet deadlines, and adapt to a fast-paced, changing environment.
Able to cohesively work in a team environment to ensure efficient and effective completion of all tasks for assigned groups.
Able to shift priorities as needed to cover multiple tasks in the process as directed by leadership.
Must possess a positive attitude which embraces customer-centric behavior, organizational cultural beliefs, company values as well as divisional requirements including efficiency, accuracy, productivity, and/or work schedule and confidentiality of information. Must be flexible to shift priorities as needed to cover multiple tasks in the process as directed by the Supervisor.
Must have a working knowledge about plan products, company initiatives, and other operational changes affecting the department.
Must be punctual and have regular attendance.
Must be able to work overtime during peak enrollment and renewal season.
Licenses and Certifications
None Required
ACCOUNTABILITIES AND ESSENTIAL FUNCTIONS
Duties of an Enrollment and Billing Specialist I
Process and maintain enrollment transactions for health, dental, vision, and other ancillary products
Maintain and reconcile eligibility, delinquency, and reinstatement
Resolve enrollment and billing issues
Respond to inquiries, phone calls, emails, and tasks, in a timely and accurate manner
Analyze and process transactions and reports
Communicate guidelines for enrollment to both internal and external customers
Meet quality/production standards as determined by leadership
Perform self-audit and peer-audit procedures and complete related quality control documents and work management processes
Comply with all laws and regulations associated with duties and responsibilities
Additional Accountabilities and Essential Functions
Perform other job-related duties as assigned, within your scope of responsibilities.
Job duties are performed in a normal and clean office environment with normal noise levels.
Work is predominantly done while standing or sitting.
The ability to comprehend, document, calculate, visualize, and analyze is required.
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