Membership Representative I
Posted on: 30 Jan 2021
Woodland Hills, CA
Job Description
Description
SHIFT: Day Job
SCHEDULE: Full-time
Responsible for enrollment, billing activities and/or maintaining assigned accounts. Pre-employment test battery may be required. Primary duties may include, but are not limited to: Responds to incoming calls and may initiate outgoing calls, providing customer service to plan members, providers and employer groups by answering benefit questions, resolving issues and educating callers. Verifies enrollment status, makes changes to records, researches and resolves enrollment system rejections; addresses a variety of enrollment questions and/or concerns received by phone or mail.
May be responsible for billing and delinquency processes for assigned groups. Ensures accuracy and timeliness of the membership and billing function. Responds to inquiries concerning enrollment processes. Maintains enrollment database. May order identification cards. Determines eligibility and applies contract language for each case assigned. Performs error output resolution for electronic eligibility and processes error discrepancy list. Bills, collects premiums and reconciles payments.
Maintains and reconciles premium bill, self-bill and individual billed accounts. Notifies clients of premium discrepancies through payment adjustment notices and detailed audits. Screens all forms and data for all paperwork received from Sales and/or Underwriting for new group and/or group re-classing benefits. Makes request to Underwriting, Sales or Brokers for missing information and/or forms needed for new group or re-class of existing group.
May be responsible for loading rates to new groups and renewal/re-class groups within the appropriate system. Screens group for benefits to determine if existing or new, recognizing when benefits are not standard and handling as appropriate. Thoroughly documents inquiry outcomes for accurate tracking and analysis. Develops and maintains positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner. Performs basic job functions with help from co-workers, specialists and managers on non-basic issues.
AnEqualOpportunityEmployer/Disability/Veteran
Qualifications
Requires a HS diploma or GED; up to 1 year of related experience; or any combination of education and experience, which would provide an equivalent background. Advanced knowledge and proficiency in Microsoft Excel.
Anthem, Inc.
Indianapolis, IN
Anthem, Inc., through its subsidiaries, operates as a health benefits company in the United States. It operates through three segments: Commercial & Specialty Business, Government Business, and Other. The company offers a spectrum of network-based managed care health benefit plans to large and small group, individual, Medicaid, and Medicare markets. Its managed care plans include preferred provider organizations; health maintenance organizations; point-of-service plans; traditional indemnity plans and other hybrid plans, such as consumer-driven health plans; and hospital only and limited benefit products.
The company also provides a range of managed care services to self-funded customers, including claims processing, underwriting, stop loss insurance, actuarial services, provider network access, medical cost management, disease management, wellness programs, and other administrative services. In addition, it offers an array of specialty and other insurance products and services, such as dental, vision, life and disability insurance benefits, radiology benefit management, and analytics-driven personal health care guidance; and Medicare administrative services.
Further, the company provides services to the federal government in connection with the Federal Employee Program; and operates as a licensee of the Blue Cross and Blue Shield Association. As of December 31, 2018, it served 40 million medical members through its affiliated health plans. The company was formerly known as WellPoint, Inc. and changed its name to Anthem, Inc. in December 2014. Anthem, Inc. was founded in 1944 and is headquartered in Indianapolis, Indiana.
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IndustryHealthcare
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No. of Employees63,900
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Website
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Jobs Posted1634
