Enrollment Analyst II - Kelsey Seybold Clinic - Pearland Business Office

About the role

This role involves managing and processing enrollment applications for KelseyCare Advantage across different health plan options. It includes handling calls from members, clinics, or health plan reps to sort out any eligibility queries, as well as making calls to confirm members' enrollment status. The job requires analyzing eligibility documents, using a variety of system applications and databases to process files, addressing eligibility edits, and keeping the enrollment system data updated for over 100,000+ managed care members. As a go-to person for initial level escalated eligibility issues, this position also offers guidance and expertise to level I Enrollment Analysts. Additionally, the role covers updating member eligibility, supporting the processing of data files from employer group health plans, managing enrollments, handling necessary member communications, and helping with system testing.

Responsibilities

• Manage and process enrollment applications for KelseyCare Advantage across different health plan options
• Handle calls from members, clinics, or health plan reps to sort out any eligibility queries
• Make calls to confirm members' enrollment status
• Analyze eligibility documents
• Use various system applications and databases to process files
• Address eligibility edits
• Keep the enrollment system data updated for over 100,000+ managed care members
• Offer guidance and expertise to level I Enrollment Analysts
• Update member eligibility
• Support the processing of data files from employer group health plans
• Manage enrollments
• Handle necessary member communications
• Help with system testing

Requirements

• High school diploma or equivalent
• 3+ years of experience in eligibility/enrollment within the managed care industry
• Proficient in Microsoft Office Suite, including Access, Excel, Word, and Outlook
• Excellent written and verbal communication skills
• Proven ability to read and interpret technical reports
• Proven ability to analyze and interpret data using Microsoft Excel and Access and provide feedback to appropriate personnel
• Proven to be flexible; able to work independently or in a team environment; able to work overtime as needed
• Proven to be detailed and able to work with minimum supervision to meet strict deadlines

Qualifications

• Some college or technical school
• Prior experience in customer service in healthcare Industry
• Prior experience with Medicare Advantage
• Working knowledge of Epic Tapestry system
• Working knowledge of TriZetto Enrollment Administration Manager (EAM) application

Skills

• Strong organizational and time management skills
• Ability to handle multiple tasks simultaneously
• Attention to detail
• Customer service orientation
• Technical proficiency with Microsoft Office Suite

Benefits

In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).