- USA
- 17.00 per hour
- Hourly
- Full Time Remote
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POSITION RESPONSIBILITIES:
The Enrollment Specialist is responsible for maintaining accurate and complete eligibility information electronically and manually. The incumbent interprets group summary plan descriptions to assist plan participants and client contacts on all issues related to eligibility.
The incumbent is expected to communicate professionally with peers, supervisors, subordinates, vendors, customers, and the public, and to be respectful and courteous in the conduct of this position.
ESSENTIAL JOB FUNCTIONS:
Essential job functions include the following. Other functions may be assigned as business conditions change.
1. Enrolls new plan participants in the claims processing system and updates these records for coverage changes and terminations.
2. Meets or exceeds company standards for production and quality.
3. Requests additional information regarding eligibility from client contacts as needed.
4. Coordinates new employee and status change information with the ID Card Generator.
5. Maintains all participant status information in permanent enrollment logs.
6. Checks claim payments for each terminated employee and coordinates refund requests with Claims Examiners as needed.
7. Reports terminated employees to COBRA Specialist for COBRA processing.
8. Answers customer service telephone calls and meets personally with participants to discuss eligibility issues.
9. Updates plan participant address information as received.
10. Word-processes and sends requests for student status information for all plan participants with active dependents over the age dictated by the groups' plan documents.
11. Word-processes and sends letters requesting certificates of creditable coverage for new enrollees and generates and sends certificates for terminated employees.
12. Maintains enrollment files.
13. Contributes to the daily workflow with regular and punctual attendance.
14. Document calls into Chronolog for future referral (by typing in highlights of the conversation.)
NON-ESSENTIAL JOB FUNCTIONS:
1. Generates lists for clients identifying individuals whose COBRA coverage will terminate.
2. Coordinates legal issues with compliance officer to provide answers to clients and participants.
3. Performs related or other assigned duties as required or directed.
SUPERVISION EXERCISED:
None.
PHYSICAL WORKING CONDITIONS:
Physical requirements are representative of those that must be met to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Sitting 90%
Bending Some
Kneeling Some
Computer Screen High (visual acuity corrected to 20/30)
Lifting up to 40 lbs.
Walking 5%
Telephone Yes
Standing 5%
Manual Dexterity Medium
Reaching Some
JOB SPECIFICATIONS:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Minimum Education: High school graduation or GED required.
Certification(s) Required: None.
Minimum Experience: Experience with computers and customer service required.
Other Qualifications: ▪ Excellent oral and written communication skills required.
▪ PC skills, including Windows, Word and Excel. Must be able to adapt to software changes as they occur.
▪ Ability to learn all functions of the claims processing software program as is necessary for enrollment functions and adapt to software changes as they occur.
▪ Knowledge of the laws governing the Consolidated Omnibus Budget Reconciliation Act of 1985.
▪ Knowledge of the laws governing the Health Insurance Portability and Accountability Act of 1996.
▪ Ability to enter data with accuracy and precision.
▪ High level of interpersonal skills to work effectively with others.
▪ Ability to organize and recall large amounts of information including interactions with employees, agents, plan participants and clients.
▪ Ability to read, analyze and interpret benefit summary plan descriptions, insurance documents and regulations.
▪ Ability to project a professional image and positive attitude in any work environment.
▪ Ability to comply with privacy and confidentiality standards.
▪ Ability to analyze and solve problems with professionalism and patience, and to exercise good judgment when making decisions.
▪ Ability to operate typical office equipment.
▪ Working knowledge of general office procedures.
*Allegiance Benefit Plan Management, INC is an Equal Opportunity Employer. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.