Enrollment Resolution Specialist I (Remote)

Capital District Physicians Health Plan Inc; Town of De Witt (NY); On-site; USD 29,000 - 48,000; Full time

Job summary

Capital District Physicians' Health Plan Inc (CDPHP) is seeking an Enrollment Resolution Examiner to resolve complex enrollment and billing issues for external customers, including government agencies, under management direction and policy. The role spans multiple enrollment areas and emphasizes accuracy and compliance.

Level I focuses on reconciliation, documentation updates, and reporting, while Level II adds mentorship, subject-matter expertise, and cross-functional project representation

Qualifications

• Three (3) years' experience with financial data or Health Insurance Enrollment experience.
• Capable of establishing constructive relationships with all levels of internal and external stakeholders.
• Must be able to prioritize assignments and work accurately and independently within established time frames.
• Must be flexible and able to adjust to rapidly changing priorities.
• Solid communication skills - both verbal and written.
• Proven organizational, analytical, and time management skills.
• Computer proficiency, including experience in Microsoft Office Suite.
• Strong attention to detail and accuracy.

Responsibilities

• Reconcile enrollment data across regulatory guidelines and policies to ensure accurate payments.
• Review and update member/subscriber/group documentation to resolve discrepancies.
• Investigate financial balancing issues and support process improvements for productivity and customer satisfaction.
• Prepare regular operational reports on transactions and processing guidance.
• Coordinate with internal and external customers to resolve problems and document procedures.

Skills

Communication skills

Analytical skills

Time management

Attention to detail

Prioritization

Education

Associate degree in finance or accounting

Tools

Microsoft Office Suite

Job description

Capital District Physicians' Health Plan Inc (CDPHP) is seeking an Enrollment Resolution Examiner to resolve complex enrollment and billing issues for external customers, including government agencies, under management direction and policy. The role spans multiple enrollment areas and emphasizes accuracy and compliance.

Level I focuses on reconciliation, documentation updates, and reporting, while Level II adds mentorship, subject-matter expertise, and cross-functional project representation