Enroll Analyst

Company Name:
Premera Blue Cross
Job Summary:
With little supervision, will verify enrollment status, determine eligibility and apply contract language for each enrollment scenario. Make changes to records, research and resolve enrollment system rejections, and address a variety of enrollment questions or concerns received by phone or mail from customers or members of the business community. Validate Identification Cards are generated timely, utilizing various databases for tracking and reporting. Also provides contract and web portal training as needed, including brokers.
1. Responsible for reviewing plan provisions and applying specific rules inherent to each enrollment scenario. Apply contractual, state and federal guidelines as appropriate and utilize various databases in support of business rule application.
2. Coordinate enrollment exception processing, document enrollment specific in support of quality measures and create and edit complex electronic enrollment files for system upload.
3. Update the Medco Pharmacy system in support of urgent enrollment conditions.
4. Meet and sustain all department production, performance, and quality standards.
5. Ensure timely and accurate identification card and various fulfillment materials are prepared for new and existing members.
6. Assist with enrollment auditing as required.
7. Prepare written communications utilizing department standards and templates.
8. Identify and perform complex plan and accumulator transfers, as well as research, audit, and resolve electronic enrollment transactions.
9. Respond to or make requests for information from internal and external business partners while exhibiting above average customer service skills. These requests could consume up to 25% of your daily workload. Provide basic enrollment training which will include Web based applications.
10. Special projects as assigned.
Minimum Qualifications:
High School diploma or GED
One (1) year work experience
Preferred Qualifications:
Two (2) years of experience in Accounting/Finance/Bookkeeping
Health or insurance industry experience
Previous customer service experience
Knowledge, Skill and Abilities:
1. Data entry and keyboarding skills with ability to use 10 key.
2. Working knowledge of computer software such as Excel, Word, and Windows-based applications.
3. Good written and verbal communications skills along with the ability to effectively communicate with internal & external customers.
4. Ability to work independently, displaying skills in the areas of decision making, problem solving and self-motivation, and also as a contributing member of a team.
5. Ability to perform simple to complex enrollment activities and research, work effectively and efficiently to meet deadlines and manage workload, accuracy and production requirements.
6. Good math aptitude and problem solving skills
7. Ability to positively adapt to change.
8. Excellent organizational skills and the ability to prioritize and respond to multiple demands and timelines.
9. Ability to collect data, establish facts and draw valid conclusions.
Working Environment:
Work is performed within a normal office environment with ambient temperatures.
Ability to work overtime as required
Physical Requirements:
The following have been identified as essential physical requirements of this job and must be performed with or without an accommodation:
This is primarily a sedentary role which requires the ability to exert up to 10 lbs. of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. This role requires the ability to keyboard and to communicate clearly and understandably in person, and over the telephone.
EOE - Equal Opportunity Employer. Minorities, women, veterans and individuals with disabilities are encouraged to apply.
Job Title: Enroll Analyst
Job ID: 9284
Location: Mountlake Terrace, WA
Full/Part Time: Full-Time
Regular/Temporary: Regular

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