Enrollment Specialist

Our purpose, to improve customers’ lives by making healthcare work better, is far from ordinary. And so are our employees. Working at Premera means you have the opportunity to drive real change by transforming healthcare. 

As an Enrollment Specialist, you will join the Membership and Billing team within the Operations division. In this role, you will review and process paper and electronic enrollment applications, apply plan specific rules and regulations, and determine eligibility for each enrollment scenario. Perform plan changes to customer accounts, research and resolve enrollment discrepancies, and address a variety of enrollment tasks, questions or concerns by phone, mail, or email from internal and external customers. You’ll have a big impact on customer satisfaction by addressing and resolving urgent escalated customer needs in a timely manner.

This is a virtual/telecommuter position, working from home.

What you will do:

• Responsible for reviewing and processing paper and electronic plan applications, plan changes and other member eligibility or payment related requests 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.
• Coordinate and manage enrollment and eligibility exception processes to ensure contract guidelines are met.
• Meet and sustain all department production, performance, and quality standards and remain current on company/departmental policies and procedures.
• Prepare written member or group communications utilizing department standards and templates.
• Initiate and respond directly to inbound/outbound phone calls to external or internal customers.
• Communicate timely and effectively with various internal departments, producers, agents, subscribers or group administrators regarding eligibility, billing, and payment inquiries.
• Assist with enrollment auditing as business requires.
• Special projects and/or other administrative duties as assigned.

What you will bring:

• High School diploma or GED (Required).
• 1 year work experience (Required).
• Data entry experience preferred.
• Must have proficient skill using Excel, Word, and Windows-based applications.
• Health or insurance industry experience.
• Previous customer service experience.
• Detail orientated.