Enrollment and Billing Representative at CareerBuilder

Posted in Other 19 days ago.

Location: Madison, Wisconsin





Job Description:

It's more than a career, it's a calling.

WI-Dean Health Plan 1277 Deming



Worker Type:

Regular



Job Summary:

Determines applicant eligibility for enrollment and continuation or extension of coverage in accordance with contracts, member certificate, and other regulatory entities. Provides eligibility information and acts as a liaison for enrollment and eligibility issues. Reconciles enrollment related discrepancies.



Job Responsibilities and Requirements:



PRIMARY RESPONSIBILITIES


  • Reviews enrollment applications to determine initial and ongoing eligibility of individuals for coverage according to applicable contracts.

  • Processes quality assurance and error reports to ensure appropriate coverage for members.

  • Prepares and adjudicates member and group accounts for billing; and prepares statements on a monthly and quarterly basis.

  • Identifies and escalates problems and opportunities to the manager.

  • Maintains compliance with internal and regulatory standards.

  • Initiates billing and enrollment adjustments and coordinates reconciliation of billing problems with accounts receivable staff.

  • Answers and assists customer matters with internal departments and external groups.

  • Provides back-up support to the enrollment and billing staff as needed.

  • Performs other duties as assigned.



EDUCATION


  • High school diploma or equivalent



EXPERIENCE


  • Two years' experience



PHYSICAL REQUIREMENTS


  • Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs.

  • Frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements.

  • Frequent use of vision and depth perception for distances near (20 inches or less) and far (20 feet or more) and to identify and distinguish colors.

  • Frequent use of hearing and speech to share information through oral communication. Ability to hear alarms, malfunctioning machinery, etc.

  • Frequent keyboard use/data entry.

  • Occasional bending, stooping, kneeling, squatting, twisting and gripping.

  • Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs.

  • Rare climbing.




Work Shift:

Day Shift (United States of America)



Job Type:



Employee



Department:

97230188 700445-Enrollment and Billing



Scheduled Weekly Hours:

40


SSM Health complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex.


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