Enrollment Specialist

Axelon Services Corporation

Marshfield, WI

JOB DETAILS
LOCATION
Marshfield, WI
POSTED
13 days ago


Job Title: Enrollment Specialist



Location: [Location]



Pay: [Pay]



Primary Responsibilities

  • Ensure positive customer interactions with Security Health Plans members.
  • Interact with members, applicants, providers, and agents via telephone.
  • Identify customer concerns and research and resolve inquiries in a timely manner.
  • Participate in continual training and coaching to enhance customer service skills.


Essential Job Functions

  • Provide accurate and timely answers to benefit, coverage, premium, and claims questions to ensure member satisfaction.
  • Coordinate out-of-area or non-affiliated provider referrals for members requiring care outside of the service area.
  • Answer Center for Medicare and Medicaid Services (CMS) test calls to ensure compliance with CMS guidelines.
  • Assist Federally Facilitated Marketplace (FFM) members in updating financial and subsidy information for ACA compliance.
  • Document interactions with members electronically to maintain accurate member records.
  • Utilize electronic systems to verify and assist members with wellness benefits queries.
  • Troubleshoot online portal and secure email issues for member access to information.
  • Assist members in filing complaints or grievances using internal and/or federal guidelines.
  • Participate in continual coaching to maintain call volume, processing metrics, and accuracy goals.
  • Regular attendance is required to carry out the essential functions of the position.
  • Review and meet ongoing competency requirements to maintain role-specific skills and abilities.


Additional Duties

  • Assist current Medicare Advantage members with plan changes using CMS-provided scripts.
  • Perform other duties as assigned.


Job Qualifications



Education

  • Minimum Required: None
  • Preferred/Optional: Associate or Bachelors Degree in business administration.


Experience

  • Minimum Required: Two years experience with customer service and proficiency in handling high-pressure situations.
  • Preferred/Optional: Experience working in a health insurance call center.


Certifications/Licenses

  • Minimum Required: None

About the Company

A

Axelon Services Corporation