Grand Rapids, Michigan
2017-06-20 Job ID: 9012 Category: Professional
- 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.
- Previous enrollment processing experience and astute analytical skills to interpret complex eligibility files and data
- High School diploma - Required
- Associate' s Degree - Preferred
- Two years experience in a health related field - required
- Minimum of two years managed care experience - required
- Must have attention to detail and team-oriented
- Must have excellent communication skills
- Excellent analytical and problem-solving skill are required
- Decision-making skills are essential as is the ability to assume responsibilities as delegated
- Must have strong organizational skills, with attention to detail and ability to multi-task, mange multiple priorities and meet deadlines.
- Enrollment Position Experienced - Preferred
- Excellent computer skills proficiency with Microsoft Office applications - Required