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Enrollment & Billing Specialist II

Louisiana Blue · Baton Rouge, LA · 2 wk ago
AccountingFull-time

About the Role

This posting is for two Enrollment & Billing Specialist II vacancies within different lines of business. Candidates may be considered for either opportunity:

  • ASO Enrollment & Billing Team, reporting to Jamie Judson
  • Fully Insured Enrollment & Billing Team, reporting to Nichole Guillot

Residency in or relocation to Louisiana is preferred for all positions.

Position Purpose

The Enrollment and Billing Specialist II must be able to perform the work of an E&B Specialist I, maintain and reconcile eligibility, delinquency, and reinstatement issues, analyze and process transactions and reports, process member-level refunds, and work cohesively in a team while shifting work tasks and priorities as needed.

Nature and Scope

This role does not manage people and reports to a Supervisor, Enrollment & Billing. The incumbent must maintain contact with various departments, including Accounting, Actuarial, BET, Claims, Compliance, Customer Service, Finance, Legal, Sales and Marketing, Underwriting, IT, District Offices, Producers, Group Leaders, Brokers, 834 vendors, and all levels of Enrollment and Billing personnel.

Qualifications

  • High School Diploma or equivalent is required; Associate's degree is preferred.
  • 2 years of clerical experience is required.
  • 1 year of Enrollment and Billing experience is required (required experience can run concurrently).
  • 1 year of operational, marketing, and/or customer service experience is preferred.

Skills and Abilities

  • Understanding of insurance and working knowledge of enrollment and billing functions and the FACETS system.
  • Strong organizational and analytical abilities, effective interpersonal skills.
  • Ability to research, analyze, and resolve enrollment and billing issues.
  • Working knowledge of relevant software (MS Word, Excel, Outlook, etc.) and related corporate programs, including SMA (preferred), Common Query, CMOD, and Benefit Focus.
  • Working knowledge to apply company policies and procedures, company guidelines, state and federal laws and mandates (e.g., HIPAA, COBRA, PPACA).
  • Strong verbal and communication skills with the ability to interpret and convey information tactfully and professionally.
  • Ability to make quick, appropriate decisions with minimal supervision, learn quickly, multitask, and prioritize work to meet deadlines.
  • Able to work cohesively in a team environment and shift priorities as needed.
  • Positive attitude embracing customer-centric behavior, organizational cultural beliefs, and company values.
  • Working knowledge of plan products, company initiatives, and operational changes affecting the department.
  • Punctuality and regular attendance.
  • Ability to work overtime during peak enrollment and renewal season.

Responsibilities

  • Process and maintain enrollment transactions for health, dental, vision, and other ancillary products.
  • Maintain and reconcile eligibility, delinquency, and reinstatement issues.
  • Resolve enrollment and billing issues.
  • Respond to inquiries, phone calls, emails, and tasks in a timely and accurate manner.
  • Analyze and process transactions and reports.
  • Communicate enrollment guidelines to both internal and external customers.
  • Meet quality/production standards as determined by leadership.
  • Perform self-audit and peer-audit procedures and complete related quality control documents and work management processes.
  • Comply with all laws and regulations associated with duties and responsibilities.
  • Perform other job-related duties as assigned within your scope of responsibilities.

Physical Demands

  • Job duties are performed in a normal and clean office environment with normal noise levels.
  • Work is predominately done while standing or sitting.
  • Ability to comprehend, document, calculate, visualize, and analyze is required.

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