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Member Enrollment Representative I (3735)

Open 20d

Summary

Processes healthcare enrollment forms (e.g., ChoiceBuilder applications) by entering data into internal systems, verifying accuracy, and reporting errors to corrections/team leads. Ensures compliance with HIPAA and carrier guidelines while supporting MPC leadership with administrative tasks.

Purpose of Position:

The Member Enrollment Rep I will be responsible for providing ongoing support to the MPC leadership team through various tasks.

Essential Functions:

  • Process ChoiceBuilder Enrollment Applications, Change Request forms, Termination Notices and any other member and group related forms by entering data into the Opportunity system and adhering to departmental and carrier guidelines
  • Review document processed for accuracy against information entered in the database.
  • Ability to identify and report discrepancies/errors to corrections team
  • Ability to identify and report systematic discrepancies/errors to the PMD Submission team
  • Thoroughly test PMD Submission tickets as applicable.
  • Submit timely responses to carriers, brokers, agencies, groups and members when required
  • Help identify any specific needs in training, system enhancements and areas of improvement based on your experience and errors found during processing
  • Understanding of company policies and procedures as they apply to Choice Builder plans and products
  • Complete department training as assigned by your direct supervisor/manager
  • Adhere to all HIPAA (Health Insurance Portability and Accountability Act) and PHI (Personal Health Information) guidelines
  • Any and all duties and special projects as assigned by your direct supervisor/manage
  • On-site regular attendance and punctuality are essential functions of the job.
  • Remote, as applicable, regular attendance and punctuality are essential functions of the job.
  • Performs other business tasks or functions as assigned.

See also

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