Enrollment Representative (Remote Option within SHP Service Area)) (marshfieldclinichealthsystems)

Job Description

Come work at a place where innovation and teamwork come together to support the most exciting missions in the world!

Job Title:

Enrollment Representative (Remote Option within SHP Service Area))

Cost Center:

682891380 SHP-Enrollment Services

Scheduled Weekly Hours:

40

Employee Type:

Regular

Work Shift:

40 Normal (United States of America)

Job Description:

JOB SUMMARY

The SHP Member Eligibility Representative is responsible for determining eligibility and performing the full range of eligibility, enrollment, and disenrollment processes for all product lines. The Enrollment Representative is responsible for learning and adhering to complex regulatory requirements, as it relates to eligibility, as established by state and federal statutes, Centers for Medicare Services (CMS), Office of Commissioner of Insurance (OCI), and Department of Health Services (DHS). The position requires a strong focus on member and sponsor retention through accurate and timely resolution of issues and functions with minimal direction.

JOB QUALIFICATIONS

EDUCATION

For positions requiring education beyond a high school diploma or equivalent, educational qualifications must be from an institution whose accreditation is recognized by the Council for Higher Education and Accreditation.

Minimum Required: High School Diploma or equivalent.

Preferred/Optional: Post-secondary courses in insurance, business, health information management, or related field.

EXPERIENCE 

Minimum Required: 1 year of experience in a business or customer service setting which requires a high degree of attention to detail, and basic administrative skills involving regular computer based work.

Preferred/Optional:  2 years’ of experience working in insurance or business setting.  Proficiency with computers, involving use of database systems and Microsoft office applications.

CERTIFICATIONS/LICENSES 

The following licensure(s), certification(s), registration(s), etc., are required for this position.  Licenses with restrictions are subject to review to determine if restrictions are substantially related to the position.

Minimum Required: None

Preferred/Optional:  None

Marshfield Clinic Health System is committed to enriching the lives of others through accessible, affordable and compassionate healthcare.  Successful applicants will listen, serve and put the needs of patients and customers first.

At Marshfield Clinic Health System, we are fully committed to addressing health equity, diversity and inclusion for our employees and providers, our patients, and the communities we serve. We believe that every individual should have the opportunity to attain their highest level of health. We embrace diversity and welcome differences in who we are and how we think. We believe that any individual or group should feel welcomed, respected and valued. View our Equity and Inclusion Statement here.

Exclusion From Federal Programs: Employee may not at any time have been or be excluded from participation in any federally funded program, including Medicare and Medicaid.  This is a condition of employment.  Employee must immediately notify his/her manager or the Health System’s Compliance Officer if he/she is threatened with exclusion or becomes excluded from any federally funded program.

Marshfield Clinic Health System is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.