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Membership Rep I

  • Job Family: Customer Care
  • Type: Full time
  • Date Posted:
  • Req #: JR38673

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    Description

    Responsible for enrollment, billing activities and/or maintaining assigned accounts. Pre-employment test battery may be required.  

    Looking for someone to work Pacific time eventually.

    Primary duties may include, but are not limited to:

    • Responds to incoming calls and may initiate outgoing calls, providing customer service to plan members, providers and employer groups by answering benefit questions, resolving issues and educating callers.
    • Verifies enrollment status, makes changes to records, researches and resolves enrollment system rejections; addresses a variety of enrollment questions and/or concerns received by phone or mail.
    • May be responsible for billing and delinquency processes for assigned groups. Ensures accuracy and timeliness of the membership and billing function. Responds to inquiries concerning enrollment processes. Maintains enrollment database.
    • Determines eligibility and applies contract language for each case assigned.
    • Performs error output resolution for electronic eligibility and processes error discrepancy list.
    • Bills, collects premiums and reconciles payments.
    • Maintains and reconciles premium bill, self-bill and individual billed accounts.
    • Notifies clients of premium discrepancies through payment adjustment notices and detailed audits.
    • Screens all forms and data for all paperwork received from Sales and/or
    • Underwriting for new group and/or group re-classing benefits.
    • Makes request to Underwriting, Sales or Brokers for missing information and/or forms needed for new group or re-class of existing group.
    • May be responsible for loading rates to new groups and renewal/re-class groups within the appropriate system.
    • Screens group for benefits to determine if existing or new, recognizing when benefits are not standard and handling as appropriate.
    • Thoroughly documents inquiry outcomes for accurate tracking and analysis.
    • Develops and maintains positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner.
    • Performs basic job functions with help from co-workers, specialists and managers on non-basic issues.  

    Requirements

    • Requires a HS diploma or GED and related experience; or any combination of education and experience which would provide an equivalent background.

    Please be advised that Elevance Health only accepts resumes from agencies that have a signed agreement with Elevance Health. Accordingly, Elevance Health is not obligated to pay referral fees to any agency that is not a party to an agreement with Elevance Health. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

    Be part of an Extraordinary Team

    Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.

    We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

    We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

    The health of our associates and communities is a top priority for Elevance Health. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Elevance Health approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws.

    Elevance Health has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World’s Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.ElevanceHealth.com. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ability@icareerhelp.com for assistance.

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