Data Entry – Open Enrollment

Job Description

REQUIREMENTS

• Education: High School Diploma or GED.
• Experience: Prior experience in enrollment processing, particularly with Medicaid, Medicare, or Commercial enrollment. Experience with specific systems, such as Facets is preferred.
• Technical Competencies:
• Ability to work remotely and independently.
• Strong attention to detail.
• Strong interpersonal, time management, and organizational skills.
• Good oral/written communication and analytical skills.
• Ability to work in a fast-paced environment and navigate multiple systems, often using dual monitors.

RESPONSIBILITIES

• Reviewing and reconciling member records: This includes reviewing eligibility dates, plans, primary care provider (PCP) information, and other relevant details.
• Comparing and reconciling enrollment information: Comparing enrollment information to relevant files, such as 834 files, and making necessary adjustments to ensure correct data is present.
• Enrolling new or reinstated members: Processing requests to enroll new members or reinstate existing ones.
• Reviewing and reconciling Third Party Liability (TPL) records: Examining and reconciling records related to third-party liability.
• Following procedures and standards: Adhering to team procedures, including HIPAA policies and procedures, and meeting established performance standards for quality, turnaround time, and productivity.
• Maintaining internal customer relations: Interacting with staff to address enrollment issues, conducting research, and ensuring accurate and complete enrollment record information.
• Contacting members or other involved parties: Reaching out to insured individuals or other parties to obtain additional or missing information.
• Maintaining detailed records: Keeping accurate records of all member interactions.

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