Enrollment & Billing Representative

Company :

Job Description : 

JOB SUMMARY

This job is responsible for enrollment and billing activities for the membership, Enrollment & Billing department. Performing membership and billing activities for clients and/or members.  Duties include verifying enrollment status, making changes to records, addressing enrollment questions or concerns, resolving membership and billing issues, and accessing/updating enrollment and billing databases.

ESSENTIAL RESPONSIBILITIES

• Communicate effectively with internal and external contacts to promptly resolve discrepancies in membership and billing information and to promptly provide accurate responses to written, telephone and online inquiries
• Process and maintain membership data. Manage multiple production oriented tasks and responsibilities.
• Perform various billing, accounts receivable, and reconciliation activities.
• Create and distribute membership/billing materials and communications to clients/members.
• Ensures acceptable service levels, metrics, and/or other performance guarantees are met.
• Conduct research to ensure issue resolution. 
• Other duties as assigned or requested.

EDUCATION

Required

• High school diploma / GED

Substitutions

• None

Preferred

• Associates Degree in Business or a related field OR
• Bachelor’s Degree in Business or a related field

EXPERIENCE

Required

• 3 years of related, progressive experience (exempted experience requirements effective August 2016)
• Experience using Microsoft Office Applications 
• Experience in Billing/Enrollment and/or Customer Service

Preferred

• Prior finance related experience
• Prior healthcare industry experience
• Prior Enrollment and Billing experience

LICENSES or CERTIFICATIONS

Required

• None

Preferred

• None

SKILLS

• Strong financial aptitude
• Solid customer service/phone skills
• Attention to detail
• Organizational skills
• 10-key data entry with both quality and speed
• Basic accounting knowledge and ability to reconcile enrollment and/or payment information
• Proven ability to analyze and resolve problems
• Knowledge of principles and processes for providing customer service, including customer needs assessment and meeting standards.
• Ability to handle many tasks simultaneously and respond to customers and their issues promptly and professionally.  
• Ability to take direction and to navigate through multiple systems simultaneously.
• Ability to maintain composure under stressful and fast-paced conditions.

Language (Other than English):

None

Travel Requirement:

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office-based

Teaches / trains others regularly

Occasionally

Travel regularly from the office to various work sites or from site-to-site

Occasionally

Works primarily out-of-the office selling products/services (sales employees)

Never

Physical work site required

Yes

Lifting: up to 10 pounds

Constantly

Lifting: 10 to 25 pounds

Occasionally

Lifting: 25 to 50 pounds

Never

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement : This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times.  In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. 
Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability. 

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