Member Enrollment Representative I

Mass General Brigham Health Plan; Somerville (MA); Remote; USD 35,000 - 50,000; Full time

Job summary

A leading healthcare organization is looking for an Enrollment Representative in Somerville, MA. This remote role involves handling enrollment tasks for commercial business, addressing complex member issues, and ensuring excellent customer service. Candidates should have experience in customer service and a high school diploma, while familiarity with healthcare administration is preferred. Competitive salary and benefits offered.

Benefits

Competitive salary

Flexible work options

Career growth opportunities

Qualifications

• 1-2 years in a customer service, administrative, or enrollment role required.
• Ability to translate complex topics and provide exceptional service.
• Strong aptitude for technology and proactive problem-solving.

Responsibilities

• Handle complex enrollment issues and assist with daily operations.
• Navigate multiple systems to resolve member inquiries.
• Meet productivity and quality control goals.

Skills

Customer service skills

Interpersonal skills

Technology aptitude

Communication skills

Problem-solving

Education

High School Diploma or Equivalent

Associate's Degree Healthcare Administration

Job description

Overview

Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are on the forefront of transformation with one of the world's leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage.

Our work centers on creating an exceptional member experience - a commitment that starts with our employees. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise within a consciously inclusive environment where diversity is celebrated. We are pleased to offer competitive salaries, and a benefits package with flexible work options, career growth opportunities, and much more.

As part of the Member Enrollment Team, you will be responsible for the enrollment tasks primarily for the commercial line of business, which includes the entry of information into MGBHP's enrollment system and working with reports to resolve discrepancy issues. As business need requires, you will provide back up support for other lines of business, such as Medicaid and Medicare. As an enrollment representative you will have many interactions with internal and external clients as well as group administrators, therefore excellent customer service skills are essential. Other duties include, assisting with monthly reconciliation, assisting on special projects as needed, and researching discrepancy reports. In addition, you will also help with other general administrative duties and special projects as assigned.

Responsibilities

• Dealing with complex enrollment issues from either internal representatives, external vendors, or sales and account executive staff. These issues include but are not limited to eligibility, pharmacy, billing and group set up.
• Provide back up support for daily operations in team member's absence.
• Responsible for navigating various systems (QNXT, Revs, GIC Magic, etc) to resolve member issues.
• Responsible for understanding the distinction between different lines of business (Medicaid, Commercial, C-Chip, C-Choice, etc.).
• Meet or exceed daily productivity goals.
• Meet or exceed monthly QC goal.
• Responsible for reviewing daily error reports.
• Participating and engaging in all team meetings.
• Attend meetings/represent the department on projects as needed.
• Anticipates and meets, or exceeds, internal and/or external customer expectations and requirements; establishes and maintains effective relationships within the organization.
• Hold self and others accountable to meet commitments.
• Persist in accomplishing objectives to consistently achieve results despite any obstacles and setbacks that arise.
• Other duties as assigned with or without accommodation.

Education

• High School Diploma or Equivalent required and Associate's Degree Healthcare Administration or the equivalent combination of training and experience preferred

Experience

• At least 1-2 years of experience in a customer service, administrative, or enrollment role required

Knowledge, Skills, and Abilities

• Demonstrate Mass General Brigham Health Plan's core brand principles of always listening, challenging conventions, and providing value
• Bring fresh ideas forward by listening to and working with employees and the people we serve
• Respect the talent and unique contributions of every individual and treat all people in a fair and equitable manner
• Strong, demonstrated track record of an ability to execute on time
• Strong aptitude for technology-based solutions
• Ability to inject energy, when and where it's needed
• Current in healthcare trends
• Demonstrated forward, visionary thinking; ability to see "what is" and envision "what could be"
• Ability to develop, introduce, defend, and gain support for a new ideas and approaches
• Ability to translate and communicate complex topics in a variety of forums
• Strong verbal, active listening, and written communication skills required
• Ability to challenge the status quo and drive innovative thinking and the capability to successfully implement strategy
• Excellent interpersonal skills, including the ability to influence others at all levels of an organization
• Strong EQ; exercises self-awareness; monitors impact on others; is receptive to and seeks out feedback; uses self-discipline to adjust to feedback
• Unquestionable integrity

Working Conditions

• This is a remote role that can be done in most US states
• This is a Monday through Friday role and the schedule will likely be 8 AM - 4:30 PM ET

Mass General Brigham Health Plan Holding Company, Inc. is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.