Enrollment Specialist III

Overview:  The Enrollment Specialist III is responsible for the enrollment of Claims Management and Claims Management Pro clients for electronic claim, ERA, and eligibility transactions.

Duties and Responsibilities:

• Works the enrollments setup inbox, processing approval and rejection emails from the payers, processing EDI and ERA enrollment forms at the provider or colleague request and processing EDI and ERA forms when there are no payer agreements to generate.


• Works directly with the Implementation Supervisor to identify customer enrollment issues and improve the enrollment process.


• Answers incoming customer calls regarding Salesforce cases, status checks, missing ERA’s, processing of the Enrollment forms and general enrollment questions.


• Generate .pdf documents where applicable.


• Works the Aggregator Setup Inbox by processing any enrollments that come in and researching missing electronic remittances.


• Provide assistance to Enrollment Representatives with internal questions and training on day-to-day operations.


• Prepares and sends all spreadsheets for enrollment of electronic remittances to all appropriate recipients.


• Other duties assigned by the Implementation team supervisor.


• Maintain compliance with Inovalon’s policies, procedures and mission statement.


• Adhere to all confidentiality and HIPAA requirements as outlined within Inovalon’s Operating Policies and Procedures in all ways and at all times with respect to any aspect of the data handled or services rendered in the undertaking of the position.


• Fulfill those responsibilities and/or duties that may be reasonably provided by Inovalon for the purpose of achieving operational and financial success of the Employer.

Job Requirements:

• 2-4 years of experience in call center or related experience.


• Healthcare EDI Knowledge preferred.


• Knowledge of Insurance Payer Forms and Insurance Billing preferred.


• Proficient in use of Microsoft Office suite (MS Word, MS Excel, MS Outlook and PowerPoint).


• Proficient in working with Adobe Reader.


• Proficient in working with CRM systems (Salesforce Preferred).


• Experience in working with Operating Systems such as Linux and Windows.


• Excellent verbal and written customer service skillset.


• Self-motivated with strong organizational/prioritization skills and ability to multi-task with close attention to detail.


• Ability to work efficiently in a fast–paced environment.


• Ability to work independently, assisting others as needed.


• A strong team player with the ability to interact effectively with all parts of the organization.

Education:

• High School diploma or G.E.D. required


• Associate's degree preferred

Physical Demands and Work Environment:

• Sedentary work ( i.e. sitting for long periods of time).


• Exerting up to 10 pounds of force occasionally and/or negligible amount of force.


• Frequently or constantly to lift, carry push, pull or otherwise move objects and repetitive motions.


• Subject to inside environmental conditions.


• Travel for this position will include less than 5% locally usually for training purposes.