Membership Representative I - 121845
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.
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.
**Job** *Membership & Enrollment*
**Title:** *Membership Representative I - 121845*
**Requisition ID:** *121845* 4bff51aff1a0472f9cfcd186d
We recently changed our name from WellPoint to Anthem, Inc., the name people know us by best. As our companies continue to take a more active role in helping people access the right health care and programs, going by a name that people know and trust is important.
Anthem, Inc. is one of the nation's leading health benefits insurer and a Fortune Top 50 company. At Anthem, Inc., we are working to transform health care with trusted and caring solutions and meaningfully advance affordability and better health outcomes for our health plan members. Nearly 69 million people are served by our affiliated companies including more than 37 million enrolled in our family of health plans.
- One in nine Americans receives coverage for their medical care through Anthem's affiliated plans.
- We offer a broad range of medical and specialty products.
Bring your expertise to our innovative, achievement-driven culture, and you will discover lasting rewards and the opportunity to help drive the future of health care.
Anthem, Inc. is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine and is a 2014 DiversityInc magazine Top 50 Company for Diversity. To learn more about our co