Enrollment Representative Lead
CHRISTUS System Office
CHRISTUS Corp Irving Offices 919 and 909 Buildings
919 Hidden Ridge
Irving, TX 75038
USView Other Locations
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The Health Plan Enrollment Representative Lead performs duties relative to financial aspects for member care including financial counseling, billing and collection of accounts, assists management with various other duties as necessary. Under the supervision of the Enrollment Manager/Supervisor, this position will provide efficient and timely processing of project request. The associate will prioritize and coordinate task and projects. This position core responsibilities include, pulling eligibility/billing data for regulatory reporting requirements, analyzing eligibility/billing data, working created statistical reports for the Enrollment Representative Team Lead. This position will be responsible for working various workgroup queues, and other duties as assigned. The core responsibilities will be aligned with the timely and accurate entry of all phases of the enrollment/billing process and coordination/communication across departments, internal and external customers, for an exceptional level of service to our members.
- Provide application assistance and facilitate enrollment of eligible members and community members health insurance programs.
- Maintain knowledge and expertise in eligibility, enrollment and billing; and program specifications for U.S. Family Health Plan, Medicare, Medicaid, and or the Federal marketplace.
- Enrollment activities for members via paper, file transfer, or internet enrollment processing.
- Consistently meet and exceed Service Level Agreements related to enrollment and disenrollment process.
- Maintain detailed tracking of each function within the enrollment and disenrollment process including correspondence and accuracy of member ID cards.
- Maintain detailed tracking of all quality data updates within the enrollment and disenrollment process.
- Communicates verbally and in writing with members, third parties and other departments as required to facilitate the enrollment, disenrollment and billing processes.
- Responds to internal and external customer inquiries regarding eligibility and related functions.
- Enters information during the enrollment process that assists claims personnel in claim adjudication including COB.
- Performs reconciliation of system data vs program data.
- Receives and works with incoming eligibility from a variety of sources.
- Consistently meets or exceed department and company standards and expectations including but not limited to quality, productivity and attendance.
- Maintain confidentiality for all customers.
- Receives, processes and respond to correspondence or phone inquiries from members.
- Compile data, tracks results and reports to management.
- Attend meeting when applicable.
- Perform other duties as assigned.
- High school diploma
- Analytic ability to organize and prioritize work to meet deadlines
- Strong computer application skills including Microsoft Word, Excel and Visio
- Excellent written and verbal skills required
- Good judgment, initiative and problem-solving abilities
- Ability to handle and resolve complex issues with little assistance
- Ability to perform multiple tasks simultaneously Ability to communicate effectively
- 3+ years Managed Care healthcare experience preferred
- Ability to obtain Common Access Card (CAC) – Requires the complications of a Public Trust Background check, Fingerprint Check, and Credit Check