Enrollment & Member Support Specialist

Geisinger; Danville (PA); On-site; USD 36,000 - 48,000; Full time

Benefits offered by this job

Healthcare benefits

Job summary

Geisinger is seeking a Customer Service professional to assist in resolving enrollment-related concerns and to educate and guide members through enrollment processes. You will support cross-functional teams and maintain high customer satisfaction in an office setting.

The role involves applying enrollment rules, generating communications, and assisting with claims and eligibility tasks to ensure accurate member records and compliant service delivery.

Qualifications

• High School Diploma or GED required.
• 1+ year experience in customer service required.

Responsibilities

• Resolve enrollment reports and related eligibility issues following policy and guidelines.
• Communicate with newly enrolled Health Plan members, dependents, and employer groups.
• Explain and apply rules in contracts and with employer groups and vendors.
• Provide data extracts and audit reports for accuracy and compliance.
• Determine member eligibility, terminations and disenrollments.
• Prepare communications to subscribers about enrollment activity.
• Verify coverage of services as per line of business and product design.
• Review suspended claims and advise on resolution according to policy.
• Assist peers with claims resolution policies and procedures.
• Support provider services staff with claims issues and guidance.
• Research claim issues and identify criteria for reconsideration of payment.

Skills

Customer Service

Education

High School Diploma or Equivalent (GED)

Job description

Geisinger is seeking a Customer Service professional to assist in resolving enrollment-related concerns and to educate and guide members through enrollment processes. You will support cross-functional teams and maintain high customer satisfaction in an office setting.

The role involves applying enrollment rules, generating communications, and assisting with claims and eligibility tasks to ensure accurate member records and compliant service delivery.