Enrollment Specialist

Group Health Cooperative of South Central Wisconsin; Madison (WI); On-site; USD 35,000 - 48,000; Full time

Job summary

A leading healthcare cooperative is seeking an Enrollment Specialist to manage membership data and respond to inquiries from members and providers. This role requires strong communication, organization, and customer service skills to effectively support our cooperative's mission of promoting health and well-being in the community. A comprehensive benefits package is included, emphasizing our commitment to employee welfare.

Benefits

Health and dental insurance

Paid short-term and long-term disability

Tuition reimbursement

Flexible spending account

Employee assistance programs

Pet insurance

Eyewear discounts

Qualifications

• At least one year of administrative office experience required.
• Knowledge of Medicare, Medicaid, and enrollment regulations needed.
• Experience in HMO or insurance-related environments preferred.

Responsibilities

• Process and maintain membership and employer data for members.
• Handle inquiries from employer groups, members, and providers.
• Participate in premium billing processes.

Skills

Customer Service

Communication

Organization

Confidentiality

Prioritization

Attention to Detail

Education

High school graduate or equivalent

Tools

MS Office Suite

Insurance Enrollment Software

Job description

Administration - 1265 John Q. Hammons Drive, Madison, Wisconsin, United States of America

Job Description

Posted Wednesday, June 18, 2025 at 5:00 AM

Group Health Cooperative of South Central Wisconsin. BETTER TOGETHER

Under the general supervision and direction of the Enrollment Supervisor, the Enrollment Specialist is responsible for accurately and promptly processing and maintaining membership and employer data for GHC-SCW members and group accounts, including those related to Medicare and Medicaid. This role also involves participating in premium billing processes and handling a high volume of inquiries from employer groups, members, and providers concerning eligibility status.

GHC-SCW is a quality driven cooperative built on collaboration, community involvement, innovation, and belonging. In dedication to the health and well-being of our employees, we offer a comprehensive benefits package that includes health and dental insurance, along with paid short-term disability, long-term disability, and life insurance. Additional benefits include a flexible spending account, employee assistance programs, tuition reimbursement, pet insurance, eyewear discounts, and more.Check us out by clicking onMany Talents, One Mission! The Benefits of Working at GHC-SCW.

Job Specific Minimum Qualifications

• High school graduate or equivalent is required.
• A minimum of one (1) year of administrative office experience is required. Experience in enrollment, billing or in an insurance or HMO related environment is preferred.
• Extensive knowledge of and /or ability to learn Medicare, Medicaid, Federal and State enrollment regulations required.
• Knowledge of and /or ability to learn procedures and practices related to HMO, medical services billing and enrollment, and knowledge of and /or ability to learn insurance enrollment software such as EPIC is required.
• Knowledge of computers including ability to use various software packages such as MS Office Suite, email, and scheduling is required.Experience in the operation of a PC, and 10-key adding machine is preferred.
• Ability to prioritize workload during heavy workload periods is required.
• Ability to communicate effectively orally and in writing is required.
• Ability to maintain patient confidentiality required. Knowledge of or ability to learn HIPAA requirements.
• Excellent customer service skills and the ability to work with diverse populations are required, including strong listening skills both on the telephone and in person.
• Ability to work independently is required.
• Ability to file numerically and alphabetically is required.
• Ability to analyze, write, plan, explain and investigate is required.
• Ability to use a keyboard extensively is required, including the ability to accurately type 40 w.p.m.
• Ability to sit extensively, stand, kneel, and lift intermittently is required.
• Ability to lift a minimum of 25 pounds is required.
• Visual acuity is required.
• Ability to work irregular hours and overtime when needed is required.
• Ability to work harmoniously and cooperatively with all personnel and the public is required.

The incumbent knows and abides by all Group Health Cooperative of South Central Wisconsin (GHC-SCW) organizational and departmental policies, sets personal standards and strives for high quality work in completing assignments, performs job duties in a timely manner, and represents the organization in a positive manner.The incumbent understands our Mission, Vision and Common Values (stated below) and is committed to promote these values in behavior and attitude.

Our Mission Statement : We partner with members and the communities we serve to maximize health and well-being.

Our Vision : As a local, not-for-profit, member-owned Cooperative, we are the most trusted resource for lifelong health and well-being in the communities we serve.

Our Values :

• We are a not-for-profit Cooperative
• We are member-centered
• We are equitable and inclusive
• We are innovative
• We are community involved

We believe:

Healthcare is a human right.

In treating all people with dignity and respect.

There is strength in diversity.

Equity celebrates our humanity.

We are better together.

Group Health Cooperative of South Central Wisconsin is proud to be an equal opportunity employer. GHC-SCW considers candidates regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.

Administration - 1265 John Q. Hammons Drive, Madison, Wisconsin, United States of America