Enrollment Services - Enrollment Processor - Commercial 160-1031

CommunityCare HMO Inc.; Tulsa (OK); Sur place; USD 32 000 - 46 000; Plein temps

Résumé du poste

CommunityCare HMO Inc. is seeking an Enrollment and Eligibility Clerk to enter and maintain enrollment data, review information for accuracy, and process related transactions. The role emphasizes compliance with guidelines and regulatory requirements.

The candidate should have strong communication, attention to detail, and the ability to multitask with minimal supervision, using Microsoft Office tools daily.

Qualifications

• Strong oral and written communication skills.
• Ability to handle multiple tasks with minimal supervision.
• Excellent organizational abilities and attention to detail.
• Able to work with personnel at various levels.
• Proficient in Microsoft Office applications.

Responsabilités

• Enter, update, and maintain enrollment data for accuracy.
• Review information for completeness and compliance with guidelines.
• Process enrollment transactions and changes.
• Maintain accurate member and client enrollment records.
• Queue or route enrollment-related correspondence as required.
• Escalate incomplete or missing information as needed.
• Ensure processing complies with internal policies and regulatory requirements.
• Perform other duties as assigned.

Connaissances

Communication

Multitasking

Organizational

Collaboration

Attention to detail

Background check

MS Office

Formation

High school diploma or equivalent

2 years administrative experience in health care/insurance

Outils

Microsoft Office

Description du poste

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