Enrollment Specialist II

2 weeks ago

Sacramento, California, United States Western Health Advantage Full time $53,000 - $75,000 per year

Summary Description:
The Enrollment Specialist II is responsible for ensuring the eligibility, enrollment, and demographic data for Western Health Advantage's commercial and sponsor membership is accurate and up-to-date. The Enrollment Specialist II must accurately communicate eligibility requirements and process incoming paper and electronic enrollment forms. The Enrollment Specialist II is expected to be able to handle high profile brokers and groups and resolve issues with minimal guidance. This position will also be called upon to train other Enrollment Specialists as needed.

Representative Duties:

  • Provide back-up phone support for calls from brokers, employer groups, and Individual Advantage members regarding eligibility and enrollment questions
  • Communicate eligibility requirements and enrollment status to brokers, employer groups, and internal departments on a regular basis
  • Responsible for basic enrollment processing such as additions, terminations, ordering ID cards, primary care physician (PCP) changes, and address changes submitted to the department via email or fax
  • Maintain a detailed and thorough working knowledge of the enrollment requirements as outlined in the Evidence of Coverage Handbook and Group Service Agreement
  • Maintain data entry accuracy and timeliness scores of 98% or higher
  • Work closely with Individual Sales and Premium Billing teams on escalated cases
  • Participate in meetings and technical calls as requested
  • Perform other duties and special projects as assigned

Qualifications:

  • High School Diploma
  • 3 years' experience working in enrollment at the health plan level; specifically, HMO is a plus
  • Previous experience working with Facets Application Software highly desired
  • Must be available to work extended hours during the regular work week as well as Saturdays during enrollment periods
  • Intermediate computer skills, including electronic mail, routine database activity, word processing, spreadsheet, graphics, etc. Specifically, the ability to create formulas and graphs in Excel and import them into Word documents
  • Must be able to speak, read, write, and understand the primary language(s) used in the workplace

Salary:
$22.00- $25.00 Hourly
Western Health Advantage is committed to providing equal employment opportunities
to employees and applicants for employment on the basis of merit and without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, physical or mental disability, medical condition, genetic information, marital status, ancestry, military or veteran status, or any other basis made unlawful by federal or state law.

Western Health Advantage values and supports the unique talents and strengths that each employee brings to our organization. Collaborating with the best and the brightest means a dynamic, fulfilling work experience for you — and excellent customer service for our members.

  • WARNING: Please beware of phishing scams that solicit interviews or promote work-at-home opportunities, some of which may pose as legitimate companies. Please be advised that Western Health Advantage will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the to the Federal Trade Commission by selecting the 'Rip-offs and Imposter Scams' option.'

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