Enrollment Processor, Intermediate

Your Role 

The IFP Install and CEC team support our consumer line of business by managing the eligibility and reconciliation of our IFP membership for both on and off-exchange membership. The Enrollment Processor, Intermediate will report to the Operations Supervisor, IFP Install. In this role you will review and reconcile eligibility data, support our vendor team with clarifications and work with internal and external stakeholders to ensure our IFP membership has accurate eligibility and rates.

Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Your Work 

In this role, you will: 

• Regularly contact internal and external customers and business partners to verify or obtain additional information to complete processing work
• Verify accuracy of entered data against source documents
• Utilize multiple sources to verify and reconcile eligibility information
• Process group or member level enrollment, cancellations and changes
• Make decisions based on review of source documents for routine and difficult processing issues
• Work with internal and external stakeholders to align eligibility and address discrepancies
• Ability to communicate effectively with internal and external business partners 

Your Knowledge and Experience 

• Requires High School Diploma or GED
• Requires at least 3 years of prior relevant experience in Health Insurance (e.g., claims, customer service, processing)
• Knowledge of Covered California Eligibility guidelines and enrollment processing preferred
• Knowledge of Facets, SAS, Edifecs, PEGA, & CalHeers preferred
• Intermediate-Advanced skills creating documents/files using Excel, Outlook, Power Point, and Word

 

Hybrid Virtual Work

This role allows employees to work virtually full-time, however employees will be expected to come to the office based on business need.