Job Description
- Handles incoming customer calls and assignments in a professional manner
- Works on assigned/required weekends and after-hours during open enrollment season
- Handles and processes all member enrollment, disenrollment, and cancelation requests; Duties include but are not limited to:
- Prints all incoming applications and disenrollments from fax or electronic enrollment via enrollment site, or OEC (mailed in (scan), emailed in)
- Verifies and print beneficiary eligibility evidence for Part A/B, Medical, and Wipro (info crossing)
- Date stamps, sorts and combines applications with eligibility into PDF packets. (Manage each application in individual folders for back up)
- Screens all incoming application and follow up with the broker for all discrepancies / missing information to ensure the application is complete
- Pre-logs application into the enrollment system for tracking and confirmation purposes
- Processes enrollment applications: Data entry of prospective members into the enrollment system for completed enrolments that have been evaluated with an assigned election type/code.
- Generates submission report and uploads enrollment application to member profile daily
- Print auto-generated notices (OEV, Client, REJ, CAN, RFI, etc.). Upload, call log, and mail out.
- Verification of members with Medical eligibility through online verification for the DSNP monthly process
- Notifies Broker Relations Department when a questionable or non-compliant pattern is identified with specific brokers
- Coordinates outbound calls with Member Services Department for research or obtaining additional information, Participating in Team chats, emails, and meetings related to Department operations
- Conducts any necessary research on questionable applications by working with supervisory staff.
- Coordinates with the Member Services Department to properly track the mailing of ID cards, and all other applicable letters/notices to members after enrollment completion
- Responsible for handling the prospective Member calls transferred/received from Member Services Department and/or other departments. Inform the Supervisor/Manager of issues encountered and provide resolution promptly
- Assists in translation and proofreading upon request from upper management and the marketing department
Qualifications
- Education: At least a high school diploma; preferable a college degree
- Experience: Preferably with one (1) year of hands-on Medicare enrollment/disenrollment background; or equivalent general healthcare background health plan, hospital administrative work, or doctor's office front desk. Preferably has some experience with healthcare member services or general customer service
- Bilingual in English and or Korean/Chinese spoken and written required – must be able to communicate effectively and professionally. Language will be tested for fluency
- Good organization skills, detail-oriented
- Able to work efficiently and can follow instructions well
- Computer skills including Word processing and Excel
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