Enrollment Services - Enrollment Processor - Commercial 160-1031

CommunityCare HMO Inc.; Tulsa (OK); On-site; USD 32,000 - 42,000; Full time

Job summary

CommunityCare HMO Inc. is seeking a diligent Enrollment Clerk to handle data entry, updates, and maintenance of enrollment and eligibility records in accordance with internal policies and applicable requirements.

You will review information for completeness, process enrollment transactions, and route related correspondence while maintaining accurate member and group records. Strong communication and Microsoft Office proficiency are essential.

Qualifications

• High school diploma or equivalent required.
• Two years in an administrative function within health care, insurance, or medical group preferred.
• Strong written and oral communication; detail-oriented with good organizational skills.

Responsibilities

• Enter, update, and maintain enrollment and eligibility data; verify accuracy.
• Review enrollment information for completeness and compliance.
• Process enrollment transactions, changes, updates, and corrections.
• Maintain accurate member, group, and customer enrollment records.
• Queue, route, or generate enrollment-related correspondence.
• Identify missing enrollment information and escalate issues as needed.
• Ensure compliance with policies, procedures, and regulatory requirements.
• Perform other related duties as required.

Skills

Oral and written communication

Multitasking

Detail oriented

Organizational skills

Team collaboration

Microsoft Office

Education

High school diploma or equivalent

Tools

Microsoft Office

Job description

JOB SUMMARY

Responsible for performing enrollment and eligibility data entry, updates, maintenance, review, transaction processing, correspondence queueing or routing, issue escalation, and compliance-based enrollment processing in accordance with established guidelines, policies, procedures, and applicable requirements.

Key Responsibilities

• Enter, update, and maintain enrollment and eligibility data; confirm for accuracy.
• Review enrollment information for completeness, accuracy, and compliance with established guidelines.
• Process enrollment transactions, changes, updates, and corrections.
• Maintain accurate member, group, and customer enrollment records through routine data maintenance.
• Queue, route, or generate enrollment-related correspondence as required.
• Identify incomplete, inconsistent, or missing enrollment information and escalation or route issues as needed.
• Ensure enrollment processing activities comply with internal policies, procedures, and applicable regulatory requirements.
• Perform other job-related duties as required or assigned.

Qualifications

• Possess strong oral and written communication skills.
• Self-motivated with the ability to handle multiple tasks and work with minimal supervision
• Strong organizational skills.
• Ability to work effectively with personnel at various levels.
• Must have high attention to detail.
• Successful completion of Health Care Sanctions background check.
• Proficient in Microsoft office applications.

Education/Experience

• High school diploma or equivalency.
• Two years working in an administrative function for a health care institution, insurance company or medical group preferred.

CommunityCare is an equal opportunity at will employer and does not discriminate against any employee or applicant for employment because of age, race, religion, color, disability, sex, sexual orientation or national origin