Job Details

Group Enrollment Specialist

Job Summary: To efficiently and effectively manage the manual enrollment process for Commercial groups while maintaining customer satisfaction.

Primary Job Responsibilities:

1. Display proven results in consistently achieving and meeting all standards and expectations for entry of eligibility data from submitted forms
   1. This may include new group setup, upgrades, terminations, and/or other changes as requested by the member/group.
2. Promptly resolve eligibility issues that may impact the business
   1. Complete proofs and prepare eligibility forms to correct missing or incorrect information often through contact with employer group administrators and/or Sales and Account Management
   2. Communicate effectively with customers, other workgroups, and/or department leaders in order to facilitate resolution, problem-solving, and ensure customer satisfaction
   3. Escalate issues to leader promptly to ensure adequate understanding, support, and tracking of issue and resolution
3. Research the available sources of information to resolve problems and answer questions. This may include, but is not limited to
   1. Refund policies for retro-terminations
   2. Escalated issues that impact the eligibility of a member(s)
   3. Over-age dependents and/or other updates that impact eligibility
4. Successfully complete cross-training in additional eligibility service areas, as assigned by manager, to assist with daily department tasks.
5. Serve as Subject Matter Expert and point of contact for high-impact eligibility issues, such as:
   1. Assist with processing eligibility claims in the filters
   2. Assist with research of the merging ID's
   3. Coordination of Benefits
   4. Daily updates to eligibility and daily inquiry report
6. Performs other related assigned duties as necessary to complete the Primary Job Responsibilities as described above.

Minimum Qualifications:
Will accept any suitable combination of education, training or experience. Position requires a high school diploma or GED, 2-years insurance operations experience, advance experience working with alphanumeric data entry and basic experience working with 10-key.
Employees are to adhere to department and corporate policies and procedures, serve internal and external customers and support the goal of other departments and the company.