Enrollment & Billing Specialist II

Enrollment And Billing Specialist II

The Enrollment And Billing Specialist II must be able to perform the work of an E&B specialist I. Maintains and reconcile eligibility, delinquency and reinstatement issues. Analyze and process transactions and reports. Process member level refunds. Analyze and process transactions and reports. Work cohesively in a team and shift work tasks and priorities as needed.

This role does not manage people. This role reports to this job : Supervisor, Enrollment & Billing. Necessary Contacts : In order to effectively fulfill this position, the incumbent must be in contact with : Accounting, Actuarial, BET, Claims, Compliance, Customer Service, Finance, Legal, Sales and Marketing, Underwriting, IT, District Offices, Producers, Group Leaders, Brokers, 834 vendors and all levels of Enrollment and Billing personnel and other BCBSLA departments as needed.

Education : High School Diploma or equivalent is required. Associate's is preferred.

Work Experience : 2 Years of clerical experience is required. 1 years of Enrollment and Billing experience is required. Required experience can run concurrently. 1 year of operational, marketing, and / or customer service experience is preferred.

Skills and Abilities : Must understand insurance and working knowledge of enrollment and billing functions and FACETS system. Must have strong organizational and analytical abilities and effective interpersonal skills. Must have the ability to research, analyze, and resolve enrollment and billing issues. Must have working knowledge of relevant software (MS Word, Excel, Outlook, etc.) and related software as other corporate programs and applications, including but not limited to SMA (preferred), Common Query, CMOD, and Benefit Focus. Must have working knowledge to apply company policies and procedures, company guidelines, state and federal laws and mandates (e.g., HIPPA, COBRA, PPACA, etc.) to ensure information is current and accurate. Must demonstrate verbal and communication skills with the ability to interpret and communicate information with tact, diplomacy, patience and professionalism. Must be able to make quick, appropriate decisions that lead to both internal and external customer satisfaction with minimal supervision, learn quickly, multitask, prioritize work to meet deadlines, and adapt to a fast-paced, changing environment.

Able to cohesively work in a team environment to ensure efficient and effective completion of all tasks for assigned groups. Able to shift priorities as needed to cover multiple tasks in the process as directed by leadership. Must possess a positive attitude which embraces customer-centric behavior, organizational cultural beliefs, company values as well as divisional requirements including efficiency, accuracy, productivity, and / or work schedule and confidentiality of information. Must be flexible to shift priorities as needed to cover multiple tasks in the process as directed by the Supervisor. Must have working knowledge about plan products, company initiatives and other operational changes affecting the department. Must be punctual and have regular attendance. Must be able to work overtime during peak enrollment and renewal season.

Licenses and Certifications : None Required.

Duties of an Enrollment and Billing Specialist I : Process and maintain enrollment transactions for health, dental, vision, and other ancillary products. Maintain and reconcile eligibility, delinquency and reinstatement. Resolve enrollment and billing issues. Respond to inquiries, phone calls, emails and tasks, in a timely and accurately manner. Analyze and process transactions and reports. Communicate guidelines for enrollment to both internal and external customers. Meet quality / production standards as determined by leadership. Perform self-audit and peer-audit procedures and complete related quality control documents and work management processes. Comply with all laws and regulations associated with duties and responsibilities.

Additional Accountabilities and Essential Functions : Perform other job-related duties as assigned, within your scope of responsibilities. Job duties are performed in a normal and clean office environment with normal noise levels. Work is predominately done while standing or sitting. The ability to comprehend, document, calculate, visualize, and analyze are required.