Job Description

JOB SUMMARY: Responsible for performing enrollment and eligibility data entry, updates, maintenance, review, transaction processing, correspondence queueing or routing, issue escalation, and compliance-based enrollment processing in accordance with established guidelines, policies, procedures, and applicable requirements.

KEY RESPONSIBILITIES

• Enter, update, and maintain enrollment and eligibility data; confirm for accuracy.
• Review enrollment information for completeness, accuracy, and compliance with established guidelines.
• Process enrollment transactions, changes, updates, and corrections.
• Maintain accurate member, group, and customer enrollment records through routine data maintenance.
• Queue, route, or generate enrollment-related correspondence as required.
• Identify incomplete, inconsistent, or missing enrollment information and escalate or route issues as needed.
• Ensure enrollment processing activities comply with internal policies, procedures, and applicable regulatory requirements.
• Perform other job-related duties as required or assigned.

QUALIFICATIONS

• Possess strong oral and written communication skills.
• Self-motivated with the ability to handle multiple tasks and work with minimal supervision
• Strong organizational skills.
• Ability to work effectively with personnel at various levels.
• Must have high attention to detail.
• Successful completion of Health Care Sanctions background check.
• Proficient in Microsoft office applications.

EDUCATION/EXPERIENCE:

• High school diploma or equivalency.
• Two years working in an administrative function for a health care institution, insurance company or medical group preferred.

CommunityCare is an equal opportunity at will employer and does not discriminate against any employee or applicant for employment because of age, race, religion, color, disability, sex, sexual orientation or national origin