Member Enrollment

Greater Boston Area, Massachusetts

Posted: 10/15/19 Category: Professional Job Number: 8402

Position: Member Enrollment
Type: contract
Duration: 3 months (possible extension but not definite)
Location: Greater Boston Area
Required: data entry, health insurance experience preferred

SUMMARY OF POSITION

As part of the Member Enrollment Team, you will be responsible for the enrollment tasks for members including the entry of information into enrollment system and working with reports to resolve discrepancy issues.

As an enrollment representative you will be responsible for entering information into the QNXT system and therefore data entry skills and quality are of the utmost importance.  Customer service skills are also essential as you will have many interactions with internal and external customers.  Other duties include assisting on special projects as needed, and researching discrepancy/troubleshooter reports. In addition, you will also provide assistance with photocopying, faxing, filing, and other general administrative duties and special projects as assigned.

 

ESSENTIAL FUNCTIONS (LIST KEY RESPONSIBILITIES IN ORDER OF IMPORTANCE AND/OR FREQUENCY.)

Learn Medicare/Medicaid and Commercial enrollment processes and guidelines.

Enter enrollments, disenrollment’ s, and changes into the eligibility system.        

Prioritize work per financial impact.

Work with Commercial Staff and other team members to resolve eligibility issues.

Communicate with Customer Service and Claims on urgent issues.

Work with Clinical for processing and reconciling enrollment issues for MH new born babies

Learn and process HFI, CMA, MH reconciliations and discrepancies, Weekly and monthly MH discrepancy reports, Research discrepancies for a response to MH e-mails    

Assist with pharmacy, site, and PCP activities that impact enrollment.

Efficiently navigating multiple systems to Research and correct errors found on discrepancy reports or E-mail.

Meet Standards for Accuracy and Quality goals

Anticipates and meets, or exceeds, internal and/or external customer expectations and requirements; establishes and maintains effective relationships with customers and gains their trust and respect.

Work with other departments and outside partners to provide the best resolution for the customer

Sense of urgency and strong communication skills on the phone, in person and via email.

Strong data entry skills and data interpretation knowledge.

Ability to read reports and take note of trends.

 

KNOWLEDGE AND EDUCATION

Required:

High School Diploma

Preferred/Desired:

College Degree

EXPERIENCE       Required:

Highly organized, with excellent written and verbal communication skills

The candidate must be able to multi-task, prioritize projects and work independently as well as effectively within a team environment

Proficient typing (25 wpm)

Excellent grammar skills 

Data Entry, problem solving, ability to meet quality and quantity standards.

Preferred/Desired:

2 years prior healthcare enrollment experience

Working knowledge of Microsoft Word and Excel                                                                                                                                                

SKILLS/COMPETENCIES                

Excellent customer service skills

Respects the talent and unique contribution of every individual, culture and ethnic group and treats all people in a fair and equitable manner

Maintain excellent attendance record                                                                                                                   

Exercises self-awareness; monitors impact on others; is receptive to and seeks out feedback; uses self-discipline to adjust to feedback

Accountable for delivering high quality work.

 

CERTIFICATION OR CONDITIONS OF EMPLOYMENT        

Pre-employment background check

CORI background check, if applicable

 

  INDEPENDENT ACTION

Carries out daily duties under direct supervision of the Member Enrollment Supervisor.

ORGANIZATIONAL RELATIONSHIPS/SCOPE (DESCRIBE THE TYPE AND LEVEL OF POSITIONS WITHIN OR OUTSIDE NHP WITH WHOM AN INCUMBENT NORMALLY INTERACTS.)

Position reports into the Member Enrollment Supervisor. This position is an entry-level position into the Enrollment/healthcare arena. 

Position will have many interactions with internal clients as well as external group administrators

Macayla Schmidt
Technical Recruiter

Contact Macayla today to learn more about this outstanding opportunity with Queen Consulting Group!

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