Senior Enrollment Operations Specialist
2 weeks ago
Position Title: Senior Process Associate
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 operational reviews, and aiding in escalation resolutions to ensure compliance with service level agreements for specific processes within the policies and standards of Infosys.
Key Responsibilities:
- Manage processes to address eligibility exceptions within mandated State/Regulatory timeframes, including enrollment file discrepancies, ID card generation issues, primary care provider assignments, and 834 enrollment files directed to vendors or third-party administrators.
- Process Coordination of COB eligibility through appropriate applications to guarantee accurate representation in the company’s enrollment system.
- Support newborn enrollment functions, including call center operations, claims processing, and verification requests, along with managing PCP assignment activities and enrollment record discrepancies.
- Provide assistance for special projects as required.
- Maintain the integrity of eligibility-related tasks.
- Conduct external communications with other health insurance providers to ascertain primary payer responsibilities.
- Prioritize daily, weekly, and monthly tasks to meet regulatory obligations and service level agreements.
- Exhibit initiative in completing assigned tasks promptly and accurately while balancing workload to support colleagues and supervisors.
- Respond knowledgeably to internal and external inquiries regarding eligibility, ID cards, primary care provider selection, and state enrollment transactions.
- Reconcile eligibility data with State Agencies using various methods, ensuring thorough documentation of all transactions.
Qualifications:
Basic Requirements:
- High School Diploma or GED Equivalent.
- A minimum of 1 year of relevant work experience.
- Strong interpersonal and communication skills to effectively engage with all organizational levels.
- Demonstrated analytical and innovative problem-solving capabilities for both strategic and tactical challenges.
- Exceptional organizational skills with a keen attention to detail and strong decision-making abilities.
- Proficient in reviewing documents for accuracy, completeness, and compliance; compiling data for reports; and drafting correspondence.
- Ability to gather and analyze data from various sources, including statutes and regulations.
About Infosys:
Infosys BPM Limited, a wholly owned subsidiary of Infosys Limited, provides comprehensive business process management services globally. Our integrated IT and BPM solutions empower clients to unlock business value across various industries and service lines, addressing their unique challenges. By leveraging innovative frameworks, continuous productivity enhancements, process reengineering, automation, and advanced technology platforms, we help clients achieve cost reduction, improve process efficiencies, and enhance customer experiences.
Infosys BPM operates 45 delivery centers across 16 countries, employing over 56,000 professionals from diverse backgrounds. Our commitment to excellence has earned us numerous accolades and recognition as a leading BPM provider worldwide. We pride ourselves on our robust people practices and have consistently been recognized as a top employer based on our industry-leading HR best practices.
Infosys is an equal opportunity employer, welcoming applicants from all backgrounds and ensuring a fair and inclusive hiring process.
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