ConnectiCare

Receive alerts when this company posts new jobs.

Similar Jobs

Job Details

Enrollment Specialist (seasonal)

at ConnectiCare

Posted: 9/6/2019
Job Reference #: 218335
Categories: Insurance
Keywords: claims

Job Description

Tracking Code
19-156T
Job Description

We are currently hiring temporary seasonal staff for our open enrollment season.

ConnectiCare is a leading health plan in the state of Connecticut. A local company for more than 35 years, ConnectiCare has a full range of products and services for businesses, municipalities, individuals and those who are Medicare-eligible. By striving to make it easy for members to get the care they need, ConnectiCare leads the individual market in the state, and is ranked among the top commercial health plans in the nation, according to the National Committee for Quality Assurance. ConnectiCare is a subsidiary of EmblemHealth.

We’re looking for individuals who want to make a difference in the communities we serve. If you want to join a local team and help change the way health care is delivered, ConnectiCare is the place for you.

Summary of Job: Maintains group and member enrollment information in conformance with legal & company guidelines, for ConnectiCare’s customers. Responsible for scrubbing of enrollment forms and data entry into automated systems. Responsible for customer service to high profile specialty groups as assigned. In a timely and accurate manner, processes member events to ensure optimum delivery of member ID cards and collateral’s. Researches errors and takes corrective action to produce best in class customer perception of service and resolution efforts.

Responsibilities:

  • As determined by business requirements, analyzes, prepares, and completes scrubbing and data entry functions of enrollment events (adds, changes, terminations etc…) in a timely and accurate manner that results in optimum delivery of ID cards and related collateral within department standards.
  • Maintains group and member data within Amisys. Enters required changes and verifies information sent by groups from billing reconciliation forms, faxes and other non-standard medium. Strives for best in class results that enhance customer perception and meets/exceeds department standards.
  • Researches exception and error reports as assigned and resolves in a timely manner. Reviews claim pend reports for eligibility and prepares claims for release or denial.
  • Communications: Works with Sales staff to gather information on groups and members. Researches and responds timely and completely to verbal and written correspondence from internal and external sources regarding enrollment issues within department standards. Resolves eligibility problems with appropriate departments to minimize impact to customer. Reviews/maintains phone log & service matrix work baskets/reports.
  • Responds to telephone calls and correspondence from customers, third party administrators and internal departments regarding member eligibility questions. Establishes commitments/expectations that are delivered on time and within department Strives for best in class performance.
  • Monitoring & Correspondence: Enter newborns and sends appropriate communication to members within department time standards. Reviews monthly reports for Medicare and obtains appropriate documents to determine Medicare eligibility. Generates HIPPA letters and communicates to affected members within department time standards. Monitors eligibility of over aged dependents, updates system, communicates dependent changes to subscribers and groups when appropriate.
  • Interfaces with other members of Operations to identify enrollment issues and take corrective actions. Identifies process improvements. Assists Billing Service Reps. in reconciling accounts and updating the system.
  • Performs other related projects and duties as assigned.

Required Skills

Qualifications:

  • High school diploma or equivalent
  • At least 1 - 2 years of previous eligibility/enrollment experience or customer service experience in an HMO or health related field
  • Data entry skills required
  • Excellent oral and written communication skills required
  • Personal computer experience required. Must be able to maintain a minimum keying standard of 10,000 keystrokes per hour with a 98% accuracy rate
  • Prioritization/organizational skills required
  • Experience with Amisys and Service Matrix desirable
  • Understanding of Managed Care laws governing members desirable

Essential Job Requirements:

  • Primarily sedentary
  • Must be able to use standard office equipment.

ConnectiCare is an equal opportunity employer. M/F/D/V
ConnectiCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Job Location
Farmington, Connecticut, United States
Position Type
Temporary