Enrollment Specialist

  • Process enrollment transactions for our Commercial Group Employers with accuracy.
  • Standard hours must be worked in office.
  • OT hours will be allowed to be worked from home/remotely.

Required Experience:

  • Previous enrollment processing experience and astute analytical skills to interpret complex eligibility files and data.
  • High School diploma.
  • Excellent computer skills proficiency with Microsoft Office applications.

Job Responsibilities:

  • Promptly and effectively process all commercial enrollment requests in compliance with all regulatory requirements and accreditation standards.
  • This includes timely entry and maintenance of data into Facets after review and analysis of electronic and hard copy information.
  • Process enrollment requests in a timely and accurate manner in compliance with state and federal regulations and accreditation standards.
  • Communicate as required with internal/external customers regarding member enrollment status through Facets documentation, phone calls and written correspondence, including use of approved form letters.
  • Analyze multiple reports from various internal and external sources to determine and implement appropriate action to reconcile enrollment discrepancies.
  • Conduct research as necessary to effectively resolve customer issues and respond to customer inquiries in a timely manner.
  • Courteously provide customers with information and education concerning government program enrollment processes and requirements.
  • Maintain an understanding of state and federal requirements and accreditation standards that impact the enrollment process.
  • Maintain an understanding of all internal and external computer systems and reports that impact the enrollment process.
  • Able to follow directions without supervision
  • Periodic over-time hours are required throughout the assignment and especially during holidays.

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