Data Entry Specialist (Enroller)

As an enrollment specialist, you will help in all aspects of health insurance enrollments including computer data-entry, interface with CRM software and data analysis.  Candidate should have skills in typing, attention to detail, and be self motivated to complete tasks efficiently.  

• Claims Processing: Accurately and efficiently process health insurance claims in compliance with company policies and industry regulations.
• Documentation: Maintain comprehensive records and documentation of all claims, ensuring accuracy and completeness.
• Communication: Collaborate effectively with healthcare providers, policyholders, and internal teams to resolve claims-related inquiries and issues.
• Adjudication: Evaluate claims based on policy terms and conditions, applying sound judgment to determine coverage eligibility.
• Timeliness: Meet or exceed established turnaround times and service level agreements for claims processing.
• Problem Solving: Investigate and resolve complex or escalated claims issues in a timely manner.
• Compliance: Stay current with industry regulations and company policies, ensuring claims processing aligns with legal and ethical standards.
• Customer Service: Provide exceptional customer service to policyholders and healthcare providers, addressing their needs and concerns professionally and courteously.
• Reporting: Generate reports and analyze claims data to identify trends, areas for improvement, and opportunities to streamline processes.
• Data Entry of enrollments in many different insurance carriers and products including marketplace plans, Short-term, ancillary, and health sharing plans.
• verifications related to ACA plans
• data entry into CRM software client information and plan information
• various reporting tasks