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Senior Enrollment Process Specialist

2 months ago

Tempe, Arizona, United States Infosys Limited Digital Full time

Position Overview:
As a Senior Process Associate, you will be responsible for executing transactions in accordance with established guidelines and timelines. Your role will involve reviewing and validating inputs from team members, assisting your manager with training initiatives, conducting daily operations reviews, and facilitating escalation resolutions to ensure adherence to service level agreements.


Key Responsibilities:

1. Manage processes to address eligibility exceptions within mandated State/Regulatory timeframes, including enrollment file discrepancies, ID card generation issues, and primary care provider assignments.

2. Process Coordination of COB eligibility to guarantee accurate representation in the company’s enrollment system.

3. Support newborn enrollment functions, which encompass call center operations, claims processing, and verification requests, as well as managing enrollment record discrepancies and disenrollment activities.

4. Provide assistance for special projects as required, while maintaining the integrity of eligibility tasks.

5. Conduct external communications with other health insurance providers to ascertain primary payer responsibilities.

6. Prioritize daily, weekly, and monthly tasks to comply with regulatory standards and service level commitments.

7. Deliver knowledgeable responses to inquiries regarding eligibility, ID cards, and state enrollment transactions.

8. Reconcile eligibility information with State Agencies through various methods and meticulously document all transactions.


Qualifications:

Basic:
- High School Diploma or GED Equivalent
- Minimum of 1 year of relevant work experience

Preferred:
- Exceptional interpersonal and communication skills to effectively engage with all organizational levels.
- Demonstrated analytical and innovative capabilities to address both strategic and tactical challenges.
- Strong organizational skills with a keen attention to detail and decision-making ability.
- Proficient in reviewing documents for accuracy and compliance, compiling data for reports, and drafting correspondence.
- Ability to research and gather relevant data, including statutes and regulations.


Note:
Applicants must possess work authorization that does not require employer sponsorship for a visa. The role involves extended periods of sitting and working at a computer.