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Job Summary

The Eligibility & Enrollment Specialist provides administrative and customer service support to agents, applicants and members related to eligibility and enrollment of individual products. Incumbent completes and processes assigned applications and change requests that do not require medical underwriting and coordinates with Underwriting to perform pre-underwriting research and development of applications that requires underwriting review. This position is classified as a customer facing role.

Requirements

EDUCATION

High school diploma or equivalent.

EXPERIENCE

Minimum two (2) years' experience in a specialized customer service environment. OR two (2) years' college (at least 48 credit hours) with one (1) year experience in a specialized customer service environment.

Must pass company proficiency test: Customer Service Assessment

ESSENTIAL SKILLS & ABILITIES

Confidentiality
Dependability
Great Phone Etiquette
Active Listening
Keyboarding
Customer Service
Teamwork
Outstanding Interpersonal Communication
Highly Organized
Detail-Oriented
Problem Solving
Oral & Written Communication
Self-Motivated Team Player
Decision Making
Mentoring
Coaching

Proficiency using Microsoft Word and Excel

Ability to work independently

Skills

• Active Listening • Computer Work • Customer Service • Decision Making • External Collaboration • Interpersonal Communication • Microsoft Excel • Microsoft Word • Oral Communications • Organizing • Problem Solving • Researching • Results Interpretation • Written Communication

Responsibilities

• Conducts pre-underwriting research and development of applications that require underwriting review and responds to requests by Underwriting to complete the application process once that review is complete • Handles outgoing correspondence for applicants, members, and agents • Identifies opportunities for process and quality improvement • Performs other duties as assigned • Processes enrollment applications and change requests by providing customer service needs both verbal and written communication, in a timely, accurate and professional manner and completes processing of underwriting and non-underwriting applications and change forms • Works closely with other departments to immediately resolve enrollment issues and communicates any processing concerns affecting potential customers and members • Works collaboratively with internal and external customers to ensure excellent service with a high level of accuracy and compliance with established audit guidelines

Certifications

Security Requirements

This position is identified as level three (3). This position must ensure the security and confidentiality of records and information to prevent substantial harm, embarrassment, inconvenience, or unfairness to any individual on whom information is maintained. The integrity of information must be maintained as outlined in the company Administrative Manual.

Segregation of Duties

Segregation of duties will be used to ensure that errors or irregularities are prevented or detected on a timely basis by employees in the normal course of business. This position must adhere to the segregation of duties guidelines in the Administrative Manual.

Employment Type

Regular

ADA Requirements

1.1 General Office Worker, Sedentary, Campus Travel - Someone who normally works in an office setting or remotely and routinely travels for work within walking distance of location of primary work assignment.