Univera Healthcare

Enrollment Specialist I/II/III/IV (Government Programs: CHP/QHP- Multiple Positions Available)

Rochester, New York, United States of America · Mid

Sponsorship not specifiedDetected 63 days ago

ComplianceExcelRecruitingHIPAAPharmacy PracticeLeadershipCommunicationProblem SolvingTime ManagementMentoringMicrosoft OfficeUnderwriting

About the role

The focus of this role is to ensure prompt, accurate, and efficient servicing of all broker, member and group administrator inquiries for all product lines.
The B version of this role will require the individual to be on the phone regularly.
Essential Primary Responsibilities/Accountabilities: Level I: Responsible for Government Programs, Small, Mid, and Large Employer Group Subscriber Enrollment Operations.

Review and assess member enrollment activity and associated documents for accuracy using knowledge and expertise of processing regulations/guidelines.
Reviews, validates and updates transaction errors from all member level electronic and paper sources impacting eligibility interfaces.
Attends provided/necessary training to support job role/function and share knowledge back with the team.
Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures.
Performs other functions as assigned by management.
Review and assess enrollment activity and associated documents for accuracy using knowledge and expertise of processing regulations/guidelines.
Acts as a resource to support and or cross train other team members.

Must have solid written and verbal communication skills.
Proven organizational, analytical, and time management skills.
Basic Computer proficiency, including experience in Microsoft Office Suite.
Ability to multi-task in order to efficiently resolve customer concerns, by understanding the needs of the customer, navigating screens on the computer, typing inquiry documentation.
B Version: Ability to actively listen to customer while simultaneously taking notes.
Ability to be on the phone regularly.
Regular and reliable attendance is expected and required.

Level I: Grade N2: Minimum: $20.00 - Maximum: $23.89 Level II: Grade N3: Minimum: $20.00 - Maximum: $26.90 Level III: Grade N4: Minimum: $20.00 - Maximum: $30.76 Level IV: Grade N5: Minimum: $20.02 - Maximum: $33.03 The salary range indicated in this posting represents the minimum and maximum of the salary range for this position.
Actual salary will vary depending on factors including, but not limited to, budget available, prior experience, knowledge, skill and education as they relate to the position's minimum qualifications, in addition to internal equity.
The posted salary range reflects just one component of our total rewards package.
This decision is made on a case-by-case basis.

Minimum of two (2) years health insurance or related operations work experience and proven ability to exercise the requirements and responsibilities of the position, preferred.
Minimum of three (3) years health insurance or related operations work experience and proven ability to exercise the requirements and responsibilities of the position preferred.

Responsible for maintaining communication, including but not limited to; Enrollment Management, Account Services Consultants, Sales, Finance/Underwriting, Claims, Customer Care, as well as interact with external Customers, groups or Brokers as necessary.
Researches, interprets and responds to inquiries from internal and external customers, business partners, brokers, consultants, and groups concerning our products, services and policies in accordance with regulatory, corporate policy, association guidelines and productivity measures.
Execution of quality service to our external, as well as internal customers by meeting productivity and accuracy metrics, compliance and member touchpoint measures (MTM) targets, and CMS processing timeframes.
Inquiries are received by the following but not limited to; telephone, email, written inquiries, lobby walk-in customers and through on-site visits with an employer group.

Actual salary will vary depending on factors including, but not limited to, budget available, prior experience, knowledge, skill and education as they relate to the position's minimum qualifications, in addition to internal equity.
The posted salary range reflects just one component of our total rewards package.
Other components of the total rewards package may include participation in group health and/or dental insurance, retirement plan, wellness program, paid time away from work, and paid holidays.
Please note: The opportunity for remote work may be possible for all jobs posted by the Univera Healthcare Talent Acquisition team.

This listing is sourced directly from Univera Healthcare's careers page and normalized into a canonical job model.