Group Enrollment Representative I (ChoiceBuilder)

Purpose of Position: The Group Enrollment Representative I is responsible for providing ongoing support to the Processing Center; to include verifying eligibility, processing group materials for participants in the ChoiceBuilder program, and other projects.  

Essential Functions:

• Understand company policies and procedures as they apply to ChoiceBuilder plans.
• Follows all established processes and procedures to ensure integrity, security and confidentiality of all data.
• Processes group voluntary terminations and reinstatements received via fax and email within 24 Hour turnaround time
• Creates and submits late pay notices as prescribed to groups and brokers
• Completes Late Payment Calls to group and brokers
• Creates and submits Term Letters to group and brokers
• Submits terminated groups to Finance via SharePoint
• Understanding of company policies and procedures as they apply to Choice Builder plans and products
• Submit timely responses to carriers, brokers, agencies, groups and members when required
• Help identify any specific needs in training, system enhancements and areas of improvement based on your experience and errors found during processing
• Communicates with clients and brokers via phone, fax or email clearly and confidently (i.e. denials, confirmation, memos, letters, etc.). Additionally, provides concise pending item requests to obtain missing or incomplete information via phone, fax or email.
• Identifies and reports inconsistencies found in the data.
• Ability to explain (verbal and written) all eligibility requirements and procedures to internal and external customers.
• Ability to enter appropriate comments in a clear and concise manner into Opportunity and/or Doc-Link.
• Ability to assess and forward documents to the appropriate team(s) or department.
• Meet and maintain department standards for quality, quantity of work, and service levels; performing the tasks and functions necessary to manage daily work bin.
• Adhere to all PHI (Personal Health Information) guidelines.
• Assist with providing feedback regarding training needs based on interaction with team member(s) or department(s).
• On-site regular attendance and punctuality are essential functions of the job.
• Performs other business tasks or functions as assigned.

Knowledge, Skills & Abilities Required:

• Strong communication skills (written, grammatical and verbal) required.
• Ability to interact and communicate effectively with all levels of employees and customers.
• Must have strong attention to detail, strong analytical skills and problem analysis/solving skills to identify trends and improve processes to resolve issues.
• Ability to perform comfortably in a fast-paced, deadline-oriented professional work environment.
• Excellent customer service and organizational skills.
• Ability to retain large quantities of information.
• Must be able to handle multiple tasks at one time.
• Accurately type a minimum of 50 WPM.
• Proficient with Microsoft Office software (Access, Word, Excel, PowerPoint, Visio, Publisher, SharePoint, Outlook), web based technology.
• Must be highly motivated, have ability to take initiative, be accountable, have excellent interpersonal, and service oriented skills.
• Knowledge of the healthcare industry a plus

Additional Competencies

• Customer Focus, Humor, Listening, Self-Knowledge, Time Management, Written Communication

In addition to the KSAs and Additional Competencies listed above, there are more competencies related to this position. Please refer to the Individual Contributor – Associate competency addendum.

Experience Requirements:

• 2 years of office and/or customer service experience required.
• At least one year of data entry experience required.

Educational Requirements:

• High school diploma or equivalent required.   

Physical Requirements: Must be able to sit for extended periods of time and occasional standing and walking.  Must have adequate hearing for phone work.  Vision requirements include close vision and the ability to adjust focus. Must be able to communicate effectively in English.  Must be able to use a keyboard and other office equipment.  Ability to lift up to 10 pounds occasionally.