What are the responsibilities and job description for the Enrollment Specialist position at Group Health Cooperative of South Central...?
Group Health Cooperative of South Central Wisconsin. BETTER TOGETHER
Under the general supervision, guidance and direction of the Enrollment Supervisor, the Enrollment Specialist is responsible for the accurate and timely processing and maintenance of all membership and employer data for GHC-SCW members and group accounts, including Medicare and Medicaid. The incumbent also participates in premium billing activities. The incumbent is responsible for responding to the large volume of inquiries from employer groups, from members, and from providers regarding eligibility status.
The incumbent knows and abides by all Group Health Cooperative of South Central Wisconsin (GHC-SCW) organizational and departmental policies, sets personal standards and strives for high quality work in completing assignments, performs job duties in a timely manner, and represents the organization in a positive manner. The incumbent understands our Mission, Vision and Common Values (stated below) and is committed to promote these values in behavior and attitude.
Job Specific Minimum Qualifications
1. High school graduate or equivalent is required.
2. A minimum of one (1) year of administrative office experience is required. Experience in enrollment, billing or in an insurance or HMO related environment is preferred.
3. Extensive knowledge of and /or ability to learn Medicare, Medicaid, Federal and State enrollment regulations required.
4. Knowledge of and /or ability to learn procedures and practices related to HMO, medical services billing and enrollment, and knowledge of and /or ability to learn insurance enrollment software such as EPIC is required.
5. Knowledge of computers including ability to use various software packages such as MS Office Suite, email, and scheduling is required. Experience in the operation of a PC, and 10-key adding machine is preferred.
6. Ability to prioritize workload during heavy workload periods is required.
7. Ability to communicate effectively orally and in writing is required.
8. Ability to maintain patient confidentiality required. Knowledge of or ability to learn HIPAA requirements.
9. Excellent customer service skills and the ability to work with diverse populations are required, including strong listening skills both on the telephone and in person.
10. Ability to work independently is required.
11. Ability to file numerically and alphabetically is required.
12. Ability to analyze, write, plan, explain and investigate is required.
13. Ability to use a keyboard extensively is required, including the ability to accurately type 40 w.p.m.
14. Ability to sit extensively, stand, kneel, and lift intermittently is required.
15. Ability to lift a minimum of 25 pounds is required.
16. Visual acuity is required.
17. Ability to work irregular hours and overtime when needed is required.
18. Ability to work harmoniously and cooperatively with all personnel and the public is required.
Our Mission Statement: We partner with members and the communities we serve to maximize health and well-being.
Our Vision: As a local, not-for-profit, member-owned Cooperative, we are the most trusted resource for lifelong health and well-being in the communities we serve.
Our Values:
Healthcare is a human right.
In treating all people with dignity and respect.
There is strength in diversity.
Equity celebrates our humanity.
We are better together.
Group Health Cooperative of South Central Wisconsin is proud to be an equal opportunity employer. GHC-SCW considers candidates regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.
Under the general supervision, guidance and direction of the Enrollment Supervisor, the Enrollment Specialist is responsible for the accurate and timely processing and maintenance of all membership and employer data for GHC-SCW members and group accounts, including Medicare and Medicaid. The incumbent also participates in premium billing activities. The incumbent is responsible for responding to the large volume of inquiries from employer groups, from members, and from providers regarding eligibility status.
The incumbent knows and abides by all Group Health Cooperative of South Central Wisconsin (GHC-SCW) organizational and departmental policies, sets personal standards and strives for high quality work in completing assignments, performs job duties in a timely manner, and represents the organization in a positive manner. The incumbent understands our Mission, Vision and Common Values (stated below) and is committed to promote these values in behavior and attitude.
Job Specific Minimum Qualifications
1. High school graduate or equivalent is required.
2. A minimum of one (1) year of administrative office experience is required. Experience in enrollment, billing or in an insurance or HMO related environment is preferred.
3. Extensive knowledge of and /or ability to learn Medicare, Medicaid, Federal and State enrollment regulations required.
4. Knowledge of and /or ability to learn procedures and practices related to HMO, medical services billing and enrollment, and knowledge of and /or ability to learn insurance enrollment software such as EPIC is required.
5. Knowledge of computers including ability to use various software packages such as MS Office Suite, email, and scheduling is required. Experience in the operation of a PC, and 10-key adding machine is preferred.
6. Ability to prioritize workload during heavy workload periods is required.
7. Ability to communicate effectively orally and in writing is required.
8. Ability to maintain patient confidentiality required. Knowledge of or ability to learn HIPAA requirements.
9. Excellent customer service skills and the ability to work with diverse populations are required, including strong listening skills both on the telephone and in person.
10. Ability to work independently is required.
11. Ability to file numerically and alphabetically is required.
12. Ability to analyze, write, plan, explain and investigate is required.
13. Ability to use a keyboard extensively is required, including the ability to accurately type 40 w.p.m.
14. Ability to sit extensively, stand, kneel, and lift intermittently is required.
15. Ability to lift a minimum of 25 pounds is required.
16. Visual acuity is required.
17. Ability to work irregular hours and overtime when needed is required.
18. Ability to work harmoniously and cooperatively with all personnel and the public is required.
Our Mission Statement: We partner with members and the communities we serve to maximize health and well-being.
Our Vision: As a local, not-for-profit, member-owned Cooperative, we are the most trusted resource for lifelong health and well-being in the communities we serve.
Our Values:
- We are a not-for-profit Cooperative
- We are member-centered
- We are equitable and inclusive
- We are quality-driven
- We are innovative
- We are community involved
Healthcare is a human right.
In treating all people with dignity and respect.
There is strength in diversity.
Equity celebrates our humanity.
We are better together.
Group Health Cooperative of South Central Wisconsin is proud to be an equal opportunity employer. GHC-SCW considers candidates regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.
