Enrollment Support Specialist

State of Washington; Olympia (WA); Hybrid; USD 52,000 - 78,000; Full time

Job summary

Washington Health Benefit Exchange seeks an Enrollment Specialist to support the enrollment life cycle in Washington Healthplanfinder. You will conduct end-to-end account analysis, use reconciliation tools, and update enrollment systems while handling customer requests via phone and email.

The role may involve hybrid remote/on-site work. You will support investigators and carriers, identify trends, and ensure timely, accurate processing through reconciliation processes.

Qualifications

• Two years of experience in social services, healthcare, or health insurance settings.
• Ability to maintain a high level of confidentiality.
• Excellent written and verbal communication skills with sensitive information.
• Demonstrated ability to earn trust and professionalism in interactions.
• Very high attention to detail with clear documentation of account work.
• Strong interpersonal skills and ability to work with diverse populations.

Responsibilities

• Provide intermediate Healthplanfinder support to insurance carriers and customers.
• Process daily, weekly, and monthly reconciliation reports to ensure enrollment accuracy.
• Perform data reconciliation and analysis using Healthplanfinder and related systems.
• Support resolution of customer requests and escalations via phone and email.
• Identify enrollment data trends indicative of system issues.
• Maintain confidential client records and reporting with timely submissions.
• Assist carrier relations by participating in meetings and responding to inquiries.
• Participate in process improvement groups and Healthplanfinder enhancements.

Skills

Communication skills

Confidentiality

Attention to detail

Interpersonal skills

Planning/Prioritization

HIPAA knowledge

Tools

MS Office

Excel

Job description

The mission of Washington Health Benefit Exchange (Exchange) is to radically improve how Washington residents secure health insurance through innovative and practical solutions, an easy-to-use customer experience, our values of integrity, respect, equity and transparency, and by providing undeniable value to the health care community.

The Exchange is a public-private partnership that operates Washington Healthplanfinder, the eligibility and enrollment portal used by one in four Washington residents to obtain health and dental coverage. Through this platform, and with support from a Customer Support Center and statewide network of in-person navigators and brokers, individuals and families can shop, compare and enroll in private, qualified health plans (as defined in the Affordable Care Act) or enroll in Washington Apple Health, the state Medicaid program.

Equity is fundamental to the mission of the Washington Health Benefit Exchange. The process of advancing toward equity and becoming anti-racist is disruptive and demands vigilance to dismantle deeply entrenched systems of privilege and oppression. While systemic racism is a root cause of many societal inequities, we must also use an intersectional approach to address all forms of bias and oppression, which interact with and often exacerbate racial inequities. To be successful, we must recognize the socioeconomic drivers of health and focus on people and places where needs are greatest. As we listen to community, we must hold ourselves accountable to responding to recommendations to remedy inequitable policies, systems, or practices within the Exchange’s area of influence. Our goal is that all Washingtonians have full and equal access to opportunities, power and resources to achieve their full potential.

SUMMARY

This position will support the Enrollment Team in processing of the enrollment life cycle through the Washington Health Benefit Exchange to ensure customers are enrolled timely and accurately into the health and dental coverage they select through Washington Healthplanfinder. This position will conduct end-to-end account analysis and utilize reconciliation tools and systems to update and align Washington Health Benefit Exchange and carrier enrollment systems. This position will support the resolution of customer requests and escalations through the use of these systems and tools and through direct outreach to customers via phone and email. This position may support other projects assigned by Enrollment Leadership as needed.

• Provide intermediate Healthplanfinder support to insurance carriers and customers, including knowledge and understanding of the Healthplanfinder application, eligibility, enrollment, and reconciliation processes.
• Process daily, weekly, and monthly reconciliation reports to ensure enrollment accuracy in Washington Healthplanfinder and carrier enrollment-related systems.
• Provide working analysis and reconciliation of enrollment data using Healthplanfinder and reconciliation systems and tools.
• Support resolution of customer requests and escalations through analysis, and outreach via phone and email.
• Identify trends in enrollment data indicative of larger Healthplanfinder, EDI, or carrier system issues.
• Support data reconciliation and program integrity processes with account work and direct outreach to customers as needed.
• Maintain confidential client records, statistical data, and tracking information; submit required reporting information in a complete, accurate, and timely manner.
• Supporting carrier relations by participating in meetings, responding timely to phone calls and emails, reviewing ad-hoc reports, and responding to escalated/urgent issues.
• Participate in process improvement groups and Healthplanfinder enhancements within Operations
• Work on special projects/other duties as assigned.
• Annual activities related to Open Enrollment (OE) - before, during, and after.

REQUIRED

• Two years of experience in any of the following:
  • Assisting clients with complex issues and service needs in a social service, healthcare, or health insurance setting; or
  • Conducting analysis and utilizing tools to reconcile and correct large volumes of data.
• Ability to maintain high level of confidentiality.
• Excellent written and verbal communication skills with the ability to communicate effectively regarding complex or sensitive information or issues.
• Demonstrated ability to earn the trust, respect, and confidence of co-workers, carriers and customers through consistent honesty, forthrightness, responsibility and professionalism in all interactions.
• Very high attention to detail with the ability to provide clear documentation and deliver pristine and accurate account work.
• Strong interpersonal skills; ability to work with diverse client populations, as well as all levels of internal management and staff.
• Communication skills, Customer focus, Resourceful, attention to detail, analytical skills.
• Planning, prioritization, able to organize and manage multiple projects.
• Regulatory knowledge (i.e of HIPPA and privacy practices) and commitment to completing tasks with high quality and resources management.

DESIRED

• Broad knowledge and understanding of the health care industry, including the commercial insurance market, Medicaid, or other health delivery systems.
• Proficient in MS Office, especially MS Excel.
• Familiarity with HIPAA 834 enrollment transactions, Edifecs, or other enrollment data and systems
• Motivated self-starter with initiative to take independent action and accept responsibility for your actions.
• Well-organized, flexible, proactive, resourceful, and efficient.

Salary Information

Full Salary Range: $51,735.00 to $77,602 annually, with midpoint at $64,669.

Hiring Range: $59,495 and $64,669 annually. This is an estimate of where a qualified candidate can expect to receive an offer.

The actual salary offer will consider candidate experience, skills, qualifications, internal equity, and the market. Our compensation policy reserves the salary range above the midpoint for employees who are meeting and exceeding expectations and for growth and development, up to the maximum.

Benefits

Take a peek at our benefits package.

Working Conditions

Core business hours are 8:00 a.m. to 5:00 p.m., Monday through Friday. There are times where irregular hours will be required. The preferred duty station is our Olympia, Washington headquarters. The nature of this role relies heavily on remote and in-person collaboration. While a hybrid remote and on-site schedule may be considered, the position will require flexibility to allow for in-office availability as business needs dictate. Travel requirements will be limited, however there may be occasions where an employee is required to travel and work irregular hours to attend meetings or trainings. Duties of this position require the use of standard office furniture and equipment, including setup for remote work. The employee is responsible for providing and maintaining a safe, ergonomic, and secure workspace at their remote location.

The working conditions and physical demands are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Special Requirements

A criminal background screen will be conducted for candidates under final consideration, and if hired, every five years of employment where highly sensitive data is processed or maintained by the position. The result of this background screen must meet the Exchange’s eligibility standards.

Other Information

The above statements are intended to describe the general nature and levels of work being performed. They are not intended to be construed as an exhaustive list of responsibilities, duties and skills of personnel so classified.

This is not an employment agreement or contract. Management has the exclusive right to alter this job description at any time without notice.

Equal Opportunity Employer

All qualified applicants will receive consideration for employment without regard to race, color, religion, age, marital status, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

We participate in E-Verify. You can view the Department of Justice's Right to Work poster here.