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Enrollment & Billing Specialist II

2 months ago

Baton Rouge, United States Bcbsla Full time

Blue Cross and Blue Shield of Louisiana Jobs

We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities. We invite you to apply for a career with Blue Cross. Residency in or relocation to Louisiana is preferred for all positions. Grade 4 POSITION PURPOSE The Enrollment and Billing Specialist II must be able to perform the work of an E&B specialist I. Maintains and reconcile eligibility, delinquency and reinstatement issues. Analyze and process transactions and reports. Process member level refunds. Analyze and process transactions and reports. Work cohesively in a team and shift work tasks and priorities as needed. NATURE AND SCOPE This role does not manage people This role reports to this job: 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 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 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 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 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 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 accurately 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 The Physical Demands described here are representative of those that must be met by an employee to successfully perform the Accountabilities and Essential Functions of the job. Reasonable accommodations may be made to enable an individual with disabilities to perform the 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 predominately done while standing or sitting. The ability to comprehend, document, calculate, visualize, and analyze are required. #LI_CB1 An Equal Opportunity Employer All BCBSLA EMPLOYEES please apply through Workday Careers. Additional Information Please be sure to monitor your email frequently for communications you may receive during the recruiting process. Due to the high volume of applications we receive, only those most qualified will be contacted. To monitor the status of your application, please visit the "My Applications" section in the Candidate Home section of your Workday account. If you are an individual with a disability and require a reasonable accommodation to complete an application, please contact recruiting@bcbsla.com for assistance. In support of our mission to improve the health and lives of Louisianians, Blue Cross encourages the good health of its employees and visitors. We want to ensure that our employees have a work environment that will optimize personal health and well-being. Due to the acknowledged hazards from exposure to environmental tobacco smoke, and in order to promote good health, our company properties are smoke and tobacco free. Blue Cross and Blue Shield of Louisiana performs background and pre-employment drug screening after an offer has been extended and prior to hire for all positions. As part of this process records may be verified and information checked with agencies including but not limited to the Social Security Administration, criminal courts, federal, state, and county repositories of criminal records, Department of Motor Vehicles and credit bureaus. Pursuant with sec 1033 of the Violent Crime Control and Law Enforcement Act of 1994, individuals who have been convicted of a felony crime involving dishonesty or breach of trust are prohibited from working in the insurance industry unless they obtain written consent from their state insurance commissioner. Additionally, Blue Cross and Blue Shield of Louisiana is a Drug Free Workplace. A pre-employment drug screen will be required and any offer is contingent upon satisfactory drug testing results.

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