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Membership Representative I

Anthem

Location: Tampa, Florida
Type: Full-Time, Non-Remote
Posted on: April 27, 2021
This job is no longer available from the source.
Description
SHIFT: Day Job
SCHEDULE: Full-time
Responsible for enrollment, billing activities and/or maintaining assigned accounts. Pre-employment test battery may be required. Not a Call Center position, administrative processing enrollment position with outbound calls.
Primary duties may include, but are not limited to:
• Responds to incoming calls and may initiate outgoing calls, providing customer service to plan members, providers and employer groups by answering benefit questions, resolving issues and educating callers.
• Verifies enrollment status, makes changes to records, researches and resolves enrollment system rejections; addresses a variety of enrollment questions and/or concerns received by phone or mail.
• May be responsible for billing and delinquency processes for assigned groups.
• Ensures accuracy and timeliness of the membership and billing function. Responds to inquiries concerning enrollment processes.
• Maintains enrollment database.
• May order identification cards.
• Determines eligibility and applies contract language for each case assigned.
• Performs error output resolution for electronic eligibility and processes error discrepancy list.
• Bills, collects premiums and reconciles payments.
• Maintains and reconciles premium bill, self-bill and individual billed accounts.
• Notifies clients of premium discrepancies through payment adjustment notices and detailed audits.
• Screens all forms and data for all paperwork received from Sales and/or Underwriting for new group and/or group re-classing benefits.
• Makes request to Underwriting, Sales or Brokers for missing information and/or forms needed for new group or re-class of existing group.
• May be responsible for loading rates to new groups and renewal/re-class groups within the appropriate system.
• Screens group for benefits to determine if existing or new, recognizing when benefits are not standard and handling as appropriate.
• Thoroughly documents inquiry outcomes for accurate tracking and analysis.
• Develops and maintains positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner.
• Performs basic job functions with help from co-workers, specialists and managers on non-basic issues.
Qualifications
• Requires a HS diploma or GED; up to 1 year of related experience; or any combination of education and experience, which would provide an equivalent background.
• Managed care experience preferred.
• Enrollment processing experienced preferred
Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.