Remote Health Plan Enrollment Specialist

Geisinger; United States; Remote; USD 35,000 - 50,000; Full time

Job summary

Geisinger is seeking a Customer Service professional to assist customers, educate on plan options, and maintain high levels of satisfaction. You will be part of a collaborative team, supporting enrollment and claims workflows in a work-from-home setting based in Pennsylvania.

The role emphasizes cross-training, adherence to policies, and clear communication with members, employer groups, and providers. A high school diploma and at least one year of experience are required.

Qualifications

• High School Diploma or GED required.
• Minimum of 1 year of customer service experience.
• Strong communication and interpersonal skills.
• Ability to work independently in a remote environment.

Responsibilities

• Resolve enrollment reports and eligibility issues per policy and guidelines.
• Notify newly enrolled Health Plan members and employer groups with information and literature.
• Interpret and apply rules in contractual agreements and with employer groups.
• Prepare membership data extracts for audits and compliance.
• Review membership data in employer group modules and approve changes.
• Determine member eligibility and process terminations and disenrollments.
• Generate letters to subscribers about enrollment activity.
• Assess if services are covered benefits by line of business.
• Review suspended claims and apply policy to resolve.
• Provide guidance to staff on claims resolution policies.
• Research claim issues and criteria for reconsideration.

Skills

Communication

Customer Service

Customer Retentions

Education

High School Diploma or GED

Job description

Geisinger is seeking a Customer Service professional to assist customers, educate on plan options, and maintain high levels of satisfaction. You will be part of a collaborative team, supporting enrollment and claims workflows in a work-from-home setting based in Pennsylvania.

The role emphasizes cross-training, adherence to policies, and clear communication with members, employer groups, and providers. A high school diploma and at least one year of experience are required.