Member Service and Enrollment Specialist
Montana Health Co-op
Reports To: Director of Corporate Support
Status: Full-time, non-exempt:
Compensation: $18-$20 Hourly
To apply, please submit a resume and cover letter to firstname.lastname@example.org.
This position is responsible for providing excellent customer service for prospective and existing members. This position will be involved in researching and resolving multiple customer related issues including enrollment and billing issues, , member eligibility issues, member document review and contract and benefit issues. Candidate will be highly motivated and able to work independently without direct supervision and in a team setting.
Duties and Responsibilities:
- Resolving incoming calls or directing to appropriate team as needed.
- Researches enrollment and billing issues.
- Performs quality reviews on all member documents and annual filing documents.
- Processes walk-in member payments in the enrollment and billing system as needed on a timely basis.
- Supports the monthly invoicing process.
- Supports the monthly delinquency and termination process.
- Develops and maintains effective relationships with employers, members, and internal departments.
- Maintains good knowledge of Mountain Health Coop insurance plans.
- Maintains a professional demeanor when communicating with internal and external customers.
- Insures that responses to internal and external inquiries are responded to on a timely basis.
- Understands and complies with HIPAA regulations, , and privacy and security requirements.
- Complies with all State and Federal regulations pertaining to healthcare administration.
- Works as a team member to complete administrative duties such as updating product filing documents, member fulfillment, invoices and member letters/notices.
- Perform a variety of other professional and administrative duties as assigned. This includes coordinating special projects and events, attending training and continuing education, and providing backup and coverage for other department staff as assigned.
While performing the duties of this Job, the employee is regularly required to sit for extended periods of time and and may be required to stand, walk and stoop. The employee may occasionally lift and/or move up to 10 pounds of office supplies. Expressing or exchanging ideas by means of the spoken word and requires the ability to receive detailed information through oral communication.Will be required to work for extended periods of time using a computer, keyboard and mouse.
Knowledge, skills and abilities:
- Minimum: High School graduate or GED equivalent. Preferred: Associate or bachelor’s degree.
- Ability to obtain or already have Montana, Wyoming and Idaho health insurance producer license.
- At least two years of experience of Microsoft software including Excel, Access, Word, PowerPoint and Outlook.
- Prefer one year of experience in insurance operations, ACA billing procedures, general medical insurance, and contract benefit interpretations.
- Basic understanding of HIPAA privacy regulations and security requirements.
- Prior customer service experience preferred.
- Highly motivated and self-directing.
- Willing to adapt and contribute to a team environment.
- Possess excellent organization, multitasking and time management skills to meet the daily working needs and complete project milestones.
- Ability to communicate effectively verbally and in writing.
- Ability to be flexible, with changing priorities and adapt positively to organizational change.