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Enrollment Specialist

Cambia Health Solutions, Inc.

This is a Full-time position in Portland, OR posted July 19, 2021.

Enrollment Specialist

Portland, Oregon

Primary Job Purpose

The Enrollment Specialist establishes and maintains eligibility and provides eligibility related customer service to accounts of varying complexity and maintenance.

General Functions and Outcomes

  • Carries a full load of group enrollment changes. Can be assigned to more complex accounts.

  • Activate, review, reconcile, and maintain individual, small, large or specialized group enrollment applications. Calculate appropriate waiting period credits, eligibility data, effective date and enter member data as appropriate to calculate premiums. Information needed to maintain these accounts can come from telephone calls to or from employers, insured members, or agents, or incoming mail or fax.

  • Review benefit set up to ensure that the billing is correct. Monitor guarantee-issue rules and notify Medical Underwriting to communicate with insured members when EOI is required.

  • Provide customer service to internal and external customers by supplying information through written correspondence and responding to telephone inquiries.

  • Incorporate and apply changes made to LifeMap enrollment policies and procedures to ensure current requirements are met.

  • Ensure changes are processed through defined daily metrics to achieve established enrollment turnaround standards. Enrollment is done using mainframe, Web and Imaging systems.

  • Perform accurately and timely all eligibility tasks and assist and train less experienced staff in interpreting benefits and eligibility.

  • In support of other staff, will cross-train on a variety of jobs to provide back-up capabilities including back-up for other LifeMap Departments.

Minimum Requirements

  • Demonstrated proficiency on 10 key.

  • Demonstrated 40 wpm tying skills with 95% accuracy

  • Ability to express ideas and recommendations clearly and with a high level of professionalism in written and oral communications.

  • Proficiency with Microsoft Office software.

  • Ability to work in an Imaging environment.

  • Ability to work in a web based environment.

  • Ability to think analytically and to make sound judgments from analysis.

  • Ability to plan and organize own work.

  • Ability to work flexible hours during periods of heavy workloads.

  • Ability to exercise judgment, initiative and discretion in confidential, mature and sensitive manner.

Normally to be proficient in the competencies listed above

Enrollment Specialist I LifeMap would have a High School Diploma or GED and one year enrollment experience or equivalent combination of education and related work experience.

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