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Become An Enrollment Representative

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Working As An Enrollment Representative

  • Getting Information
  • Interacting With Computers
  • Communicating with Persons Outside Organization
  • Communicating with Supervisors, Peers, or Subordinates
  • Establishing and Maintaining Interpersonal Relationships
  • Deal with People

  • Mostly Sitting

  • Repetitive

  • $31,720

    Average Salary

What Does An Enrollment Representative Do At Kelly Services

* Responsible for accurate set up of provider records in order to assure proper payment for providers.
* Handles all implementation steps to enroll providers in the Plan to ensure timely access for members and accurate payment for providers.
* Manages the interaction with providers and office managers to ensure that all necessary information is collected and analyzed so providers can be credentialed and loaded in the system accurately according to department standards.
* Enters the provider data once the data is validated for accuracy so that providers are paid correctly from the beginning of their affiliation with the Plan.
* Acquires and demonstrates a thorough knowledge of the unique arrangements and ensures the Plan enrolls providers with those arrangements.
* Independently initiates oversight of existing provider record problems.
* Identifies system problems with provider set up and facilitates resolution so that provider payments are accurate.
* Coordinates set up and hand off of provider records to Credentialing Department.
* Completes provider data input and assures data forms are completed per BMCHP requirements.
* Reviews submitted application and supporting documentation to ensure the data captured through the enrollment process is in compliance with NCQA, applicable state requirements.
* Follows established contracting process to ensure the smooth implementation of the provider contracts.
* Tracks, maintains and communicates information pertaining to the status of contracts in accordance with the established contracting process.
* Researches, facilitates and assists with resolution of interdepartmental issues related to enrollment as identified by providers and internal BMCHP staff.
* Maintains the integrity of Provider Data in Onyx.
* Provides assistance with ongoing quality initiatives related to improved data processing and workflows.
* Provides system analysis support as needed to ensure operational compliance with Plan provider and database rules.
* Develops basic reports in Onyx in order to provide and communicate information.
* Direct supervision is received weekly

What Does An Enrollment Representative Do At Conduent

* Responds to telephone inquiries and complaints using standard scripts and procedures
* Gathers information, researches/resolves inquiries and logs customer calls
* Communicates appropriate options for resolution in a timely manner
* Informs customers about services available and assesses customer needs
* Prepares standard reports to track workload, response time and quality of input
* Conduent is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law.
* People with disabilities who need a reasonable accommodation to apply for or compete for employment with Conduent may request such accommodation(s) by clicking on the following link, completing the accommodation request form, and submitting the request by using the "Submit" button at the bottom of the form.
* For those using Google Chrome or Mozilla Firefox please download the form first: click here to access or download the form

What Does An Enrollment Representative Do At Renown Health

* Strict adherence to all Federal and State regulations and our State of Nevada department of insurance guidelines.
* Strict adherence to eligibility and enrollment criteria governed by the Centers for Medicare & Medicaid Services (CMS) Medicare Managed Care Manual.
* Ensuring all enrollment forms are audited to comply with the group’s eligibility provision, the commercial evidence of coverage, the group subscription agreement and the summary plan documents for self funded clients.
* Entering enrollment transactions timely and accurately per the enrollment procedures.
* Ensuring reconciliation of all enrollment transactions to the enrollment forms to verify appropriate family coverage and tier match Hometown Health system.
* Working closely with our group administrators/contacts and members to ensure that enrollment is processed timely and accurately to avoid delay of enrollment, termination or disruption of their benefit plan when information received is not complete.
* Managing workloads independently as well as part of a team.
* Ability to work on multiple and complex tasks with high quality results and adherence to deadlines.
* Maintain regular communication with Leadership, Enrollment Specialist, Configuration Analyst and customers.
* Following procedural lists to develop, compile and process all enrollment information received to maintain accurate membership information for billing, claims payment, ID card and Provider/Member benefit plan utilization.
* Verifying eligibility in multiple databases, including but not limited to Medicare Advantage Prescription Drug (MARx) system, the Group Eligibility Provision, Evidence of Coverage Document, Group Subscription Agreement, Group Self Funded Summary Plan Document, Departmental policies & procedures, Provider Directory before coding and entering membership into the Hometown Health’s managed care information system.
* Performing critical thinking and analysis in determining the appropriate group, benefit package and riders to assign to members.
* Provides system expertise and training to other Representatives.
* Periodically assists Enrollment Specialist with quality auditing tasks.
* Providing detailed, accurate and timely membership data entry.
* Composing and editing correspondence to internal and external customers.
* Maintaining records and files in electronic systems.
* Compiling audit-related and miscellaneous documents regarding enrollment.
* Responsible for collecting legal documents from members to verify eligibility.
* Working closely with group administrators and members to collect information requested.
* Performing other revenue-related duties as assigned.
* Works closely with Marketing Sales Team to accomplish membership goals by managing timely entry of membership.
* This position does not provide patient care .
* Incumbent should possess the skills to type a minimum of 30
* WPM adjusted for error.
* Must have strong computer skills including expert level understanding of Microsoft Office Suite, including Outlook, entry level skills in working with Excel spreadsheets and formulas in addition to possessing basic Word skills.
* The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills and efforts or work conditions associated with the job.
* It is intended to be an accurate reflection of the general nature and level of the job

What Does An Enrollment Representative Do At Unitedhealth Group

Respond to various types of member eligibility or group inquiries, including verify enrollment status, from internal and external customers Work independently Manually updating of eligibility information on a timely basis and tracking, resolving, and reporting errors and problems directly to internal / external customers Maintain eligibility information for the claims system Make additions, changes, and terminations to employee and dependent data Analyze errors and taking appropriate action to resolve errors Provide prompt, courteous and accurate replies to inquiry and or problem resolution for both internal and external customers Meet department turnaround times and accuracy metrics Team player

What Does An Enrollment Representative Do At Ameriplan & The Johnson Agency of Georgia

* Appointment Setting Email and Telephone Communication Training New Team Members Flexible Contractor Schedule We Offer: Family Health & Dental Benefits Excellent Income with potential for Bonuses & Advancement
* Call 678
* to schedule a telephone

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How To Become An Enrollment Representative

Customer service representatives typically need a high school diploma and receive on-the-job training to learn the specific skills needed for the job. They should be good at communicating and interacting with people and have some experience using computers.

Education

Customer service representatives typically need a high school diploma.

Training

Customer service representatives usually receive short-term on-the-job training, lasting 2 to 3 weeks. Those who work in finance and insurance may need several months of training to learn more complicated financial regulations.

General customer-service training may focus on procedures for answering questions, information about a company’s products and services, and computer and telephone use. Trainees often work under the guidance of an experienced worker for the first few weeks of employment.

In certain industries, such as finance and insurance, customer service representatives must remain current with changing regulations.

Licenses, Certifications, and Registrations

Customer service representatives who provide information about finance and insurance may need a state license. Although licensing requirements vary by state, they usually include passing a written exam. Some employers and organizations may provide training for these exams.

Important Qualities

Communication skills. Customer service representatives must be able to provide information in writing, by phone, or in person so that customers can understand them.

Customer-service skills. Representatives help companies retain customers by answering their questions and complaints in a helpful and professional manner.

Interpersonal skills. Representatives should be able to create positive interactions with customers.

Listening skills. Representatives must listen carefully and understand a customer’s situation in order to assist them.

Patience. Representatives should be patient and polite, especially when interacting with dissatisfied customers.

Problem-solving skills. Representatives must determine solutions to a customer’s problem. By resolving issues effectively, representatives contribute to customer loyalty and retention.

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Enrollment Representative jobs

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Enrollment Representative Career Paths

Enrollment Representative
Data Entry Clerk Office Manager
Account Manager
5 Yearsyrs
Account Manager Sales Manager Office Manager
Administrative Manager
6 Yearsyrs
Enrollment Manager Associate Director Service Director
Assistant General Manager
5 Yearsyrs
Data Entry Clerk Billing Specialist
Billing Manager
7 Yearsyrs
Billing Representative Collections Specialist Billing Specialist
Business Office Manager
8 Yearsyrs
Sales Manager Driver Call Center Representative
Call Center Manager
6 Yearsyrs
Admissions Representative Director Of Admissions Marketing Director
Chief Executive Officer
8 Yearsyrs
Human Resources Coordinator Benefit Specialist Customer Care Specialist
Customer Care Supervisor
5 Yearsyrs
Enrollment Specialist Human Resources Coordinator
Human Resources Manager
7 Yearsyrs
Benefit Specialist Account Manager Sales Consultant
Internet Sales Manager
6 Yearsyrs
Billing Representative Accounts Receivable Specialist Accounts Receivable Manager
Office Manager
5 Yearsyrs
Enrollment Specialist Specialist Account Manager
Operations Manager
7 Yearsyrs
Admissions Representative Recruiter Operations Manager
Senior Manager
10 Yearsyrs
Human Resources Coordinator Senior Technical Recruiter Senior Sales Representative
Senior Representative
5 Yearsyrs
Sales Manager Service Representative Service Supervisor
Service Lead
5 Yearsyrs
Account Manager Operations Manager Equipment Operator
Service Supervisor
6 Yearsyrs
Analyst Operations Analyst Operations Manager
Site Manager
7 Yearsyrs
Enrollment Manager Account Manager Underwriter
Team Manager
5 Yearsyrs
Analyst Finance Analyst Assistant Vice President
Vice President
8 Yearsyrs
Benefit Specialist Specialist Warehouse Associate
Warehouse Manager
5 Yearsyrs
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Enrollment Representative Demographics

Gender

  • Female

    70.1%
  • Male

    27.2%
  • Unknown

    2.7%

Ethnicity

  • White

    79.0%
  • Hispanic or Latino

    13.1%
  • Asian

    6.0%
  • Unknown

    1.4%
  • Black or African American

    0.5%
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Languages Spoken

  • Spanish

    69.8%
  • French

    9.4%
  • Mandarin

    3.8%
  • Khmer

    1.9%
  • Hawaiian

    1.9%
  • Chinese

    1.9%
  • Vietnamese

    1.9%
  • German

    1.9%
  • Hmong

    1.9%
  • Carrier

    1.9%
  • Cantonese

    1.9%
  • Italian

    1.9%
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Enrollment Representative

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Enrollment Representative Education

Enrollment Representative

Unfortunately we don’t have enough data for this section.

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Top Skills for An Enrollment Representative

MemberEligibilityCustomerServiceMedicareAdvantageProviderApplicationsFinancialObligationsDataEntryFinancialAidEnrollmentProcessEnrollmentApplicationsNewMemberCMSHealthInsuranceHealthPlansPhoneCallsInboundCallsOutboundCallsOpenEnrollmentAuditEnrollmentStatusProgramInformation

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Top Enrollment Representative Skills

  1. Member Eligibility
  2. Customer Service
  3. Medicare Advantage
You can check out examples of real life uses of top skills on resumes here:
  • Researched and reconciled member eligibility discrepancies identified via the daily Warnings and Errors Report and the Reconciliations Report.
  • Enrolled in Medicare health plans Provided Customer Service about medicare health plans Processed data for new enrollments into health plans
  • Resolved complaints of medical insurance premiums and enrollment certifications concerns for Medicare Advantage policies.
  • Managed all incoming provider applications, changes, and termination requests for the Central & Western Massachusetts area.
  • Assisted students in understanding the financial obligations related to attending the university.

Top Enrollment Representative Employers

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Enrollment Representative Videos

Annual Medicare Enrollment Period is Now Open

College of DuPage: Admissions Video 2015

Ohio's Open Enrollment for Obamacare in 2016: Everything You Need to Know

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