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The Health Plan (THP) · 22 hours ago

Enrollment Service Rep

Wheeling, WV, US

Full-time

Onsite

New Grad, Entry Level

The Health Plan (THP) is dedicated to providing quality healthcare services, and they are seeking an Enrollment Service Representative. This role involves processing enrollment and disenrollment requests while ensuring compliance with CMS guidelines and providing sales support during peak periods.

Health CareInsuranceNon ProfitWellness

Responsibilities

Communicate with current and prospective members professionally, accurately and thoroughly

Answer prospective sales phone line and route calls to appropriate licensed Sales staff

Records all calls accurately in the Customer Service Module or Medicare Call Log

Complete a variety of enrollment and disenrollment functions

Knowledge of how the Enrollment area functions affect other units and departments

Assist with the completion of a variety of reports in accordance with CMS requirements and guidelines (i.e. TRR, BEQs and EDVs)

Process correspondence

Report all suspicious issues to the Compliance Department or Departmental Manager

Keep all former, current or prospective members (and other Employee’s) Protected Health Information (PHI) confidential

Must be willing to work Overtime if required to meet the CMS timeliness requirements

Participate in external and/or internal trainings as required

Consistently display a positive attitude and acceptable attendance

Assist with lobby traffic for current and prospective members with Enrollment/Disenrollment questions and concerns

Qualification

Medicare Enrollment knowledgeCMS Regulations knowledgeTyping skillsComputer skillsTelephone communicationMathematical skillsMedical terminologyCPTICD-9 & ICD-10 codingDetail oriented

Required

High School Diploma

Typing and Computer Skills

Good telephone and communication skills

Self-starter, detail oriented, ability to prioritize and meet deadlines

Maintain confidentiality

Mathematical skills

Good work ethic (i.e. adequate learning skills, even temperament, following instructions, retains information., works well with others)

Easily adapts to changes in work requirement

Preferred

Familiar with Medicare Enrollment and Disenrollment processes

Medical terminology

Familiar with CMS Regulations and Guidelines

Knowledge of CPT, ICD-9 & ICD-10 coding

Company

The Health Plan (THP)

The Health Plan is a clinically-driven, technology-enhanced, and customer-focused health maintenance organization that manages and improves the health and well-being of its members.

Founded in 1979