The enrollment representative serves as a liaison between the company and its members and providers. You will be expected to respond to and resolve questions and issues from current and prospective members or their representatives, providers, and other relevant parties.
Job Duties and Responsibilities
- Responds to member and provider inquiries by phone, email, or walk-in
- Demonstrates appropriate soft-skills including empathy, active listening, courtesy, politeness, helpfulness, etc.
- Records, investigates, and resolves member complaints
- Educates new members and re-educates existing members regarding health plan procedures
- Logs, tracks, and documents all issues in accordance with all applicable guidelines
- Demonstrates skills necessary to perform exceptional customer experience
- Works error and exception reports in a timely manner
- Processes and creates eligibility lists and reports
Education and Qualifications
- HS diploma or GED
- 6+ months of healthcare call center or customer service experience
- Strong background in enrollment/eligibility
- Knowledge of claims processing
- Strong ability to multitask
- Good telephone skills
- Knowledge of Microsoft programs
As an enrollment representative, you will work to ensure members receive a level of service that goes beyond their expectations.