Enrollment Specialist II

Enrollment Specialist II

The Enrollment Specialist II is responsible for ensuring the eligibility, enrollment, and demographic data for Western Health Advantage's commercial and sponsor membership is accurate and up-to-date. The Enrollment Specialist II must accurately communicate eligibility requirements and process incoming paper and electronic enrollment forms. The Enrollment Specialist II is expected to be able to handle high profile brokers and groups and resolve issues with minimal guidance. This position will also be called upon to train other Enrollment Specialists as needed.

Representative Duties :

• Provide back-up phone support for calls from brokers, employer groups, and Individual Advantage members regarding eligibility and enrollment questions.
• Communicate eligibility requirements and enrollment status to brokers, employer groups, and internal departments on a regular basis.
• Responsible for basic enrollment processing such as additions, terminations, ordering ID cards, primary care physician (PCP) changes, and address changes submitted to the department via email or fax.
• Maintain a detailed and thorough working knowledge of the enrollment requirements as outlined in the Evidence of Coverage Handbook and Group Service Agreement.
• Maintain data entry accuracy and timeliness scores of 98% or higher.
• Work closely with Individual Sales and Premium Billing teams on escalated cases.
• Participate in meetings and technical calls as requested.
• Perform other duties and special projects as assigned.

Qualifications :

$22.00- $25.00 Hourly

Western Health Advantage is committed to providing equal employment opportunities to employees and applicants for employment on the basis of merit and without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, physical or mental disability, medical condition, genetic information, marital status, ancestry, military or veteran status, or any other basis made unlawful by federal or state law.

Western Health Advantage values and supports the unique talents and strengths that each employee brings to our organization. Collaborating with the best and the brightest means a dynamic, fulfilling work experience for you and excellent customer service for our members.