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Enrollment Services Representative

Blue Cross Blue Shield of Alabama
United States, Alabama, Birmingham
Apr 03, 2025
Overview

Department Overview

Enrollment Services is responsible for subscriber eligibility, enrollment, billing and collection of premiums. The area ensures the appropriate processing of various financial arrangements in addition to monitoring the payment status of accounts for purposes of group cancellation and reinstatement.

Primary Responsibilities

This position is responsible for determining eligibility, enrolling, and maintaining members for underwritten groups, self-insured groups, individual products, senior products, Federal Employee Program (FEP), and FEP Dental Blue. It is required that these functions be performed in accordance with Affordable Care Act (ACA) regulations, corporate policies and procedures, corporate guidelines, and many other Centers for Medicare & Medicaid Services (CMS) rules and regulations, while ensuring the integrity of all eligibility information. This position is also responsible for understanding and accurately communicating the details on billing, payment options, impacts of outstanding balances, and working with groups on previous balance issues. It is required that these associates respond to internal and external requests in a professional manner with the response being timely and accurate. The external requests are primarily from a Primary Group Administrator or another authorized group contact, such as a Third Party Administrator, individual and senior members, Federal Programs and CMS. This position routinely works with various internal customers and partners including Customer Service, Claims, Sales, Marketing, and Billing Services. These associates are required to manage not only the incoming call center workload for Group Enrollment, but also the workload that is delivered to these associates through multiple workflow channels. This position is also responsible for assisting with other enrollment functions and products as determined by Management. This position is responsible for evaluating, identifying and seeking out resolution to issues. This position will serve as a liaison between Customer Service and our Analysts. This position may also represent Enrollment Services at various internal meetings throughout the Company and serve as a Subject Matter Expert on various topics.

Summary of Qualifications

  • Experience in a position requiring close attention to detail
  • Demonstrated time management skills to organize and prioritize tasks
  • Experience making decisions with minimal supervision
  • Demonstrated excellent communication skills, interpreting and communicating effectively orally and in writing
  • Experience in a customer service environment
  • Demonstrated experience with error resolution
  • Demonstrated experience navigating through multiple systems simultaneously
  • Experience with Microsoft Word and Excel
  • Knowledge of billing procedures, product details, types of contracts, types of groups and processing procedures for all Individual subscribers and groups preferred
  • Knowledge of large groups enrollment preferred
  • Knowledge of the 834 electronic interface errors and error resolutions preferred
Work Location

The work location for this position will be hybrid (onsite/remote).

Terms and Agreements

By submitting a job application, I attest that all information to the best of my knowledge is true and accurate. Furthermore, I understand that any information provided by me throughout the job application process is subject to verification including, but not limited to work experience, education, assessment (test) and interviews.
We appreciate your interest in Blue Cross and Blue Shield of Alabama 'The Company'. The Company does not discriminate in hiring or employment on the basis of race, color, religion, creed, sex, sexual orientation, gender identity, national origin, age, disability, genetics, status as a disabled or protected veteran, or because of citizenship status in the case of a citizen or intending citizen. No question on this application is intended to secure information to be used for such discrimination.
Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association

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