Enrollment & Billing Director jobs in Anaheim, CA

Company Description

Enrolment/Disenrollment Coordinator position reports directly to the Enrollment Manager. Primary responsibilities are to ensure timely and accurate processing of enrollment applications, disenrollment, cancelations, and eligibility changes. Ensure all member communication materials are mailed within the required timeframes. Assist prospective and current members by responding to and resolving all inquiries related to the enrollment / disenrollment process.

Job Description

• Handles incoming customer calls and assignments in a professional manner
• Works on assigned/required weekends and after-hours during open enrollment season
• Handles and processes all member enrollment, disenrollment, and cancelation requests; Duties include but are not limited to:
  • Prints all incoming applications and disenrollments from fax or electronic enrollment via enrollment site, or OEC (mailed in (scan), emailed in)
  • Verifies and print beneficiary eligibility evidence for Part A/B, Medical, and Wipro (info crossing)
  • Date stamps, sorts and combines applications with eligibility into PDF packets. (Manage each application in individual folders for back up)
  • Screens all incoming application and follow up with the broker for all discrepancies / missing information to ensure the application is complete
  • Pre-logs application into the enrollment system for tracking and confirmation purposes
  • Processes enrollment applications: Data entry of prospective members into the enrollment system for completed enrolments that have been evaluated with an assigned election type/code.
  • Generates submission report and uploads enrollment application to member profile daily
  • Print auto-generated notices (OEV, Client, REJ, CAN, RFI, etc.). Upload, call log, and mail out.
  • Verification of members with Medical eligibility through online verification for the DSNP monthly process
  • Notifies Broker Relations Department when a questionable or non-compliant pattern is identified with specific brokers
  • Coordinates outbound calls with Member Services Department for research or obtaining additional information, Participating in Team chats, emails, and meetings related to Department operations
• Conducts any necessary research on questionable applications by working with supervisory staff.
• Coordinates with the Member Services Department to properly track the mailing of ID cards, and all other applicable letters/notices to members after enrollment completion
• Responsible for handling the prospective Member calls transferred/received from Member Services Department and/or other departments. Inform the Supervisor/Manager of issues encountered and provide resolution promptly
• Assists in translation and proofreading upon request from upper management and the marketing department

Qualifications

• Education: At least a high school diploma; preferable a college degree
• Experience: Preferably with one (1) year of hands-on Medicare enrollment/disenrollment background; or equivalent general healthcare background health plan, hospital administrative work, or doctor's office front desk. Preferably has some experience with healthcare member services or general customer service
• Bilingual in English and or Korean/Chinese spoken and written required – must be able to communicate effectively and professionally. Language will be tested for fluency
• Good organization skills, detail-oriented
• Able to work efficiently and can follow instructions well
• Computer skills including Word processing and Excel

Additional Information

Abhishek Kumar

469 409 4080