Enrollment Services - Enrollment Processor - Commercial 160-1031

CommunityCare, Inc.; Tulsa (OK); On-site; USD 38,000 - 52,000; Full time

Job summary

CommunityCare, Inc. in Oklahoma seeks an Enrollment and Eligibility Associate to enter and maintain enrollment data, review information for accuracy and compliance, and process transactions.

The role requires strong communication, attention to detail, multitasking, and proficiency with Microsoft Office; healthcare administrative experience is preferred.

Qualifications

• Strong oral and written communication required.
• Ability to handle multiple tasks with minimal supervision.
• Excellent organizational skills and attention to detail.
• Ability to work with personnel at various levels.
• Microsoft Office proficiency.
• Successful completion of Health Care Sanctions background check.
• Experience in healthcare administration is a plus.

Responsibilities

• Enter, update, and maintain enrollment and eligibility data; confirm for accuracy.
• Review enrollment information for completeness, accuracy, and compliance.
• 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 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.]
• CoT_job_summary_short
• JOB SUMMARY:

Skills

Communication skills

Multitasking

Organizational skills

Teamwork / collaborate

Attention to detail

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 cascade 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.