Enrollment Oversight & Quality Specialist
WA Other Telecommuter, United States
R
USD 41K-71K Mid-level Full Time
Tasks
- Apply contractual state and federal guidelines
- Conduct performance audits
- Contact customers or producer agents for enrollment clarification
- Create written correspondence for complex billing and enrollment issues
- Educate agents and members on membership and billing processes
- Escalate issues to ensure resolution
- Identify compliance gaps and recommend process improvements
- Maintain and track audit procedures and efficiency work
- Perform enrollment eligibility billing changes reconciliation
- Research complex systems issues impacting member eligibility
- Review plan provisions
- Review procedures and training materials for efficiency improvements
- Troubleshoot processing system and software application issues
- Update eligibility enrollment and billing accounts
Perks/Benefits
- Commuter benefits
- Counseling services
- Dental insurance
- Disability insurance
- Employee recognition program
- Fitness and well-being center
- Health insurance
- Life insurance
- Mindfulness programs
- On-site parking
- Paid time off
- Retirement plan
- Stress management programs
- Tuition assistance
- Vision insurance
- Wellness incentives
Skills/Tech-stack
Account research | Audit management | Billing | Compliance | Contract interpretation | Customer Service | Eligibility | Enrollment processing | Process Improvement | Reconciliation | Regulatory guidelines | Troubleshooting | Web portal | Written communication
Education
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