Inventory control of member and group transactions
Support the Eligibility Call Center Representatives
Ability to work with various types of member communication
Working with our IT department to investigate and validate member eligibility
Works directly with the Accounts Payable team to review and resolve any premium issues including outreach to members, clients and State officials as needed
Communicate effectively with individuals/teams in the program to ensure high quality and timely expedition of customer requests.
Participate in activities designed to improve customer satisfaction and business performance.
Use decision-support tools to answer questions, where needed.
Solve problems that are sometimes unstructured and that may require reliance on conceptual thinking. Work is frequently completed without established procedures
Maintain broad knowledge of client requirements, procedures and key contacts.
Support projects and other departments in completing tasks/projects
Other duties as required.
Essential Qualifications
Ability to work alternate schedules/hours based on the business’s need.
Bachelor’s Degree preferred or High School diploma / GED (or higher) OR 10+ years of equivalent working experience
2+ years of experience in an office setting environment using the telephone and computer as the primary instruments to perform job duties
Knowledge of managed care, labor and commercial carrier enrollment and eligibility procedures including hourly based eligibility and waiting periods.
Prior experience with premium billing and reconciliation, knowledge of 834 eligibility files and transaction sets a plus.
Fluent in COBRA, FMLA, QLE’s and other eligibility related transactions a plus
Moderate proficiency with Windows PC applications, which includes the ability to learn new and complex computer system applications
Ability to multi-task, this includes ability to understand multiple products and multiple levels of benefits within each product
