Resolve enrollment, eligibility and billing issues and inquiries timely and accurately from members, employer groups and third party administrators by phone, email and written correspondence by:
Researching and collaborating with other units or departments to find a solution
Accurately updating member records
Contacting external partners who provide services for/to HMSA's members
Providing member or group education on enrollment, billing (bill resentment) and bill payment
Support unit in performing enrollment and billing reconciliations activities for purpose of identifying discrepancies and initiating accurate and timely correction/resolution of internal as well as external processing systems. Support unit in daily enrollment functions to include processing of enrollments, disenrollment's and maintenance for members. Perform quality assurance audits of customer inquiries and member updates within constrained timeframes. Based on patterns or risk assessment, recommend improvement opportunities to provide processing efficiency and increase customer satisfaction. These can include but are not limited to identifying processing or servicing issues that can be addressed by a system or a workflow solution.
Training and Development
Performs all other miscellaneous responsibilities and duties as assigned or directed.