Enrollment Support Specialist

SEE how you can make a difference! Be part of an innovative company that cares about its associates and helps members enjoy the wonders of sight through healthy eyes and vision.

Versant Health provides vision care to 39 million members nationwide! To ensure your continued success we provide opportunities for advancement and development.
Our associates remain engaged through a comprehensive compensation and benefits package which includes health and dental insurance, tuition reimbursements, 401(k) with company match, pet insurance and FREE vision insurance for you and your family.

Scope and Purpose of Position:
Responsible for supporting client and provider calls related to access to care challenges and urgently needed enrollment updates. As appropriate update enrollment manually utilizing assigned enrollment verification methods for each client.

Essential Functions:

• Supports our Customer Service call center line to work with providers and customers to resolve member eligibility situations and complete enrollment
• Work with Clients and Account Executives to address eligibility concerns
• Input Manual Eligibility requests (mail, email or fax with an accuracy rate of 95%)
• Responsible for working to validate the eligibility for access to care situations with the appropriate customer contacts prior to manually enrolling.
• Add, change and update enrollment records manually
• Maintain proper documentation for any eligibility changes completed in accordance with defined procedural steps.
• Complete daily priority clients request using RT query functionality
• Support Department efforts related to Gateway enrollment and EDI team as necessary.
• Process eligibility Workflow and RT tickets as needed
• Support the Gateway and Manual Enrollment staff by answering calls and responding to questions as necessary
• Specific reports and special projects as needed
• Properly adhering to defined procedural definition in completing work steps and adhering to any controls, SOC or otherwise that exist.
• Adhering to privacy and confidential and proprietary company policies and procedures (i.e. HIPAA)
• Participating in any/all training and educational activities necessary to fulfill at least the minimum requirements as specified within your departmental goals This is in addition to the completion of any activities necessary for the maintenance of professional affiliations or organizational requirements
• Other duties as assigned

Education and Experience:

• Minimum High School Diploma or GED
• One year of experience as Customer Service Representative or Manual enrollment representative required
• Proficiency in Microsoft Office
• HSP system experience in processing preferred

HIPAA & Security Requirements
All Associates must comply with the Health Insurance Portability Accountability Act of 1996 (HIPAA) as it pertains to disclosures of protected health information (PHI) as described in the Notice of Privacy Practices and HIPAA Privacy Policies and Procedures. As a component of job roles and responsibilities, Associates may have access to covered information, cardholder data or other confidential customer information which must be protected at all times. As a result, Associates must explicitly adhere to all data security guidelines established within the Company’s Privacy & Security Training Program.

We take pride in our recruiting process and follow a merit-based employee recruitment practice with extensive screening steps. We will never request money from candidates who seek employment with us and will never ask for any payment as part of the recruitment process.

We provide equal employment opportunities (EEO) to all associates and applicants for employment without regard to race, color, religious beliefs, age, sex (including pregnancy), sexual orientation, gender identity or expression (including transgender status), national origin, ancestry, status as a protected veteran or disabled veteran, physical or mental disability or history of disability, genetic information, marital status, or any and all other categories protected by under applicable Federal, state or local law.

This policy extends to all associates and to all aspects of the employment relationship. Any associate who violates this policy will be subject to disciplinary action up to and including termination.