Enrollment Services - Enrollment Processor - Commercial 160-1031

JOB SUMMARY: Responsible for performing enrollment and eligibility data entry, updates, maintenance, review, transaction processing, correspondence queueing or routing, issue escalation, and compliance-based enrollment processing in accordance with established guidelines, policies, procedures, and applicable requirements.

KEY RESPONSIBILITIES:

• Enter, update, and maintain enrollment and eligibility data; confirm for accuracy.
• Review enrollment information for completeness, accuracy, and compliance with established guidelines.
• Process enrollment transactions, changes, updates, and corrections.
• Maintain accurate member, group, and customer enrollment records through routine data maintenance.
• Queue, route, or generate enrollment-related correspondence as required.
• Identify incomplete, inconsistent, or missing enrollment information and escalate or route issues as needed.
• Ensure enrollment processing activities comply with internal policies, procedures, and applicable regulatory requirements.
• Perform other job-related duties as required or assigned. 

QUALIFICATIONS:

• Possess strong oral and written communication skills.
• Self-motivated with the ability to handle multiple tasks and work with minimal supervision
• Strong organizational skills.
• Ability to work effectively with personnel at various levels.
• Must have high attention to detail.
• Successful completion of Health Care Sanctions background check.
• Proficient in Microsoft office applications.

EDUCATION/EXPERIENCE:

• High school diploma or equivalency.
• Two years working in an administrative function for a health care institution, insurance company or medical group preferred.