JOB SUMMARY: The Enrollment Data Specialist performs operational solutions to optimize membership enrollment and premium billing accuracy and collaborates and supports internal and external customers. This position researches and reconciles systemic eligibility/enrollment or premium billing /payment discrepancies to arrive at a consistently compliant disposition and operates in a fast-paced environment with frequent priority changes. The Enrollment Data Specialist is held responsible for understanding and abiding by State, Federal, and organizational guidelines for various lines of business related to Membership enrollment and reconciliation.

MINIMUM QUALIFICATIONS:

1. Education/Specialized Training/Licensure: High school diploma
2. Work Experience (Years and Area): Two (2) years related experience with health insurance, managed care, or customer service; Knowledge of eligibility files /premium billing, Medicaid, Marketplace, Medicare preferred
3. Management Experience (Years and Area): N/A

4. Software Operated: Microsoft Office ( Word, Excel, and Outlook), SQL a plus

SPECIAL REQUIREMENTS:

1. Communication Skills:
Exceptional Verbal (e.g., Public Speaking)
Writing /Composing: Correspondence / Reports

2. Other Skills: Mathematics, Medical Terminology, Research, Statistical

3. Advanced Education:

4. Work Schedule: Flexible, Overtime

5. Other Requirements:
Excellent interpersonal, verbal, written, and listening communication skills with a high level of comfort in recommending and implementing solutions.
Strong analytical, problem solving, mathematic, organizational, prioritization and time management skills.
Ability to work efficiently, pay strong attention to detail and deliver high quality results in a deadline driven environment, while effectively managing associated stress.

RESPONSIBLE TO: Supervisor/Manager

EMPLOYEE SUPERVISED: N/A