Medicare Enrollment and Eligibility Tech: Medicaid Segment
Awarded the Best Place to Work 2021, Blue Cross Blue Shield of Arizona helps to fulfill its mission of improving the quality of life of Arizonans by delivering a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.
This position is remote/hybrid within the state of AZ only
PURPOSE OF THE JOB
Performs enrollment and eligibility review and processing with minor inbound customer service calls on large-group employer accounts.
1. Required Work Experience
· 1 years of experience in health insurance, customer service, call center, medical office, or other healthcare-related field
2. Required Education
· High-School Diploma or GED in general field of study (Applies to All Levels)
3. Required Licenses
4. Required Certifications
1. Preferred Work Experience
· 2 years of experience in health insurance, customer service, call center, medical office, or other healthcare- related field
1 year of supervisory or lead experience
· 1 year of experience as an Enrollment/Eligibility Specialist (Applies to Level 2)
2. Preferred Education
· Associate's Degree in business field of study (Applies to All Levels
3. Preferred Licenses
4. Preferred Certifications
ESSENTIAL JOB FUNCTIONS AND RESPONSIBILITIES
· Process eligibility received in various formats within applicable processing system within established time-frames to adhere to corporate and performance guarantee guidelines.
· Answer calls from group representatives and brokers.
· Identify discrepancies and appropriately communicate to customer as necessary.
· Explain to customers a variety of information concerning the organization’s services, including, but not limited to rates, benefits, changes in coverage, eligibility, BCBSAZ programs etc.,
· Identify, research, process, resolve and respond to customer inquiries and correspondence via telephone, written communication and/or in person.
· Meet quality, quantity and timeliness standards to achieve individual and department performance goals as defined within the department guidelines.
· Document and record facts in regard to inquiries and correspondence by updating BCBSAZ files and system.
· Monitor and review notifications generated from erred electronic files.
· Determine and perform appropriate adjustments to files to allow for successful systematic processing.
· Perform model office testing in conjunction with Enrollment Analysts on new and renewing electronic file transfer groups
· Mentor and train level 1 employees
· Each progressive level includes the ability to perform the essential functions of any lower levels.
· The position requires a full-time work schedule.
Full-time is defined as working at least 40 hours per week, plus any additional hours as requested or as needed to meet business requirements.
· Perform all other duties as assigned.
1. Required Job Skills
· Intermediate skill in use of office equipment, including copies, fax machines, scanner and telephones (All Levels)
· Intermediate PC proficiency (Applies to All Levels)
· Intermediate proficiency in spreadsheet, database and word processing software (Applies to All Levels)
· Type >35 words per minute with 5% error rate or less (Applies to All Levels)
2. Required Professional Competencies
· Maintain confidentiality and privacy (Applies to All Levels)
· Practice interpersonal and active listening to achieve high customer satisfaction (Applies to All Levels)
· Interpret and translate policies, procedures, programs and guidelines (Applies to All Levels)
· Capable of investigative and analytical research (Applies to All Levels)
· Navigate, gather, input and maintain data records in multiple system applications. (Applies to All Levels)
· Establish and maintain working relationships in a collaborative team environment (Applies to All Levels)
· Prioritize, organize and self-manage workload in a high volume department (Applies to All Levels)
3. Required Leadership Experience and Competencies
1. Preferred Job Skills
· Advanced knowledge of enrollment and eligibility processing
· Knowledge of electronic 834 files (Applies to Level 2)
2. Preferred Professional Competencies
· Knowledge of a wide range of matters pertaining to the organization's operations (Applies to All Levels)
3. Preferred Leadership Experience and Competencies
Comply with BCBSAZ corporate and departmental policies and procedures, including, but not limited to Code Blue, Compliance, HIPAA, Computer Responsibility, Accreditation Standards, Attendance, Staff Qualifications and Quality Management Accountabilities.
BCBSAZ does not discriminate in hiring or employment on the basis of race, ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status or any other protected group.
Thank you for your interest in Blue Cross Blue Shield of Arizona. For more information on our company, see azblue.com. If interested in this position, please apply.