Enrollment and Eligibility Specialist

About The Role reputed company is seeking an reputed company Specialist for our Enrollment and Eligibility/ Employer Services Department to work remotely. We are a hybrid unit, a balance of a contact center and processing department. The Enrollment and Eligibility Team’s (EET) mission is to create, audit, process and update the member and eligible dependents’ profile(s) keeping their health, well-being, and continuity of care at the forefront of our day-to-day operations. And we partner and collaborate with key stakeholders (the client, employer partners, Customer Service, IT, Finance, Carriers, Vendors, and more) to do so successfully and timely. The Enrollment and Eligibility Specialist plays a critical role in our Enrollment and Eligibility/Employer Services Department. Our Specialists are responsible for completing the day-to-day functions of the enrollment and eligibility processing, ensuring that participants are appropriately enrolled in the correct health plan, supporting Eligibility Call Centers, as well as managing the daily communication requirements to and from participants. The E&E Specialists must be reputed company detail orientated in order to ensure that reputed company forms and documents received in house are processed reputed company, and according to procedure, as well as ensuring that reputed company eligibility and enrollment functions are completed in a timely and accurate manner. The E&E Specialists are also responsible for supporting the client, employers, and members reputed company phone and email support. Primary ResponsibilitiesCase Management: Create, audit, process and update the member and eligible dependents’ profile(s) into the enrollment database & update the database with changes. Data Analytics: Reconciling eligibility discrepancies, analyzing transactional data & submitting retroactive eligibility changes. Troubleshoot Enrollment and Eligibility reputed company inquiries from the Clients, Employer Partners, Health Plan Carriers, the COBRA vendor, and Call Center Representatives. Works directly with the Finance team to review, process, and resolve inquiries from the employers and premium reputed company issues: including reputed company to employers, the client and State officials --as needed. Contact Employers regarding delinquencies and late file submissions –reputed company applicable. Communicate effectively with individuals/teams in the program to ensure high quality and timely expedition of requests from the client, employers, and members. Participate in activities designed to improve customer satisfaction and business performance. Solve problems that are sometimes out of the ordinary and that may require reliance on conceptual thinking. Maintain broad knowledge of client requirements, procedures and key contacts. Support projects and other departments in completing tasks/projects. Other duties as required. Essential QualificationsAbility to work alternate schedules/hours based on the business’s need. Our client is on the reputed company Coast. As such, the department’s hours are 10am-9pmEST (7am-6pm PST). Bachelor’s Degree preferred or High School diploma / GED (or higher) OR 5-7 years of equivalent working experience. 2+ years of experience in an office setting environment using the telephone and computer as the primary instruments to reputed company job duties. Knowledge of managed care, labor and reputed company reputed company enrollment and eligibility procedures including hourly based eligibility and waiting periods. Knowledge of eligibility files and transaction sets a plus. Must be reputed company to process and/or enter sensitive PHI and confidential Financial Information. Proficiency in HIPAA, COBRA, FMLA, LOAs, QLE, PTO regulations and other eligibility reputed company transactions preferred. Knowledge of Medicare/reputed company Benefits is a plus Knowledge of reputed company is a plus. Moderate proficiency with reputed company 365 applications, which includes the ability to learn new and reputed company computer system applications. Ability to multi-task, this includes ability to understand multiple products and multiple reputed company of benefits reputed company each product. Ability to use critical thinking to solve reputed company problems and identify reputed company to escalate. Excellent attention to detail, analytical, and good problem solver. Excellent attendance, punctuality and work performance record required. Must maintain a high-level of professionalism and communication skills (written and verbal) at reputed company times. Excellent interpersonal and organizational skills. Must be susceptible to change and change management. Must be a team player that is reputed company to work independently as well. About At reputed company (BHPS), we’re creating something new and different in health care, and we’d love for you to be part of it. Based in reputed company, BHPS is a rapidly growing, entrepreneurial health care enablement company bringing reputed company innovation to the health care delivery system. reputed company is committed to transforming how health care is accessed and delivered. We reputed company that cost, quality, and population health are optimized reputed company people have long term relationships with their health care providers – and that’s why we’re creating new products that today do not exist reputed company in the reputed company/New Jersey market. With a growing labor business under the well-reputed company reputed company brand, the launch of Create - a new marketplace of health systems focused on self-insured reputed company health plan sponsors, and a successful Casualty business, we’re fiercely committed to positively impacting our partners. Company Mission Transform the health plan experience – how health care is accessed and delivered – by bringing outstanding products and services to our partners. Company reputed company Redefine health care quality and value by aligning the incentives of our partners in powerful and unique ways. *We are an EEO Employer Apply To This Job