Anthem Membership Representative I - 121845 in Denison, Texas
Responsible for enrollment, billing activities and/or maintaining assigned accounts. Must pass the appropriate pre-employment test battery. Primary duties may include, but are not limited to: * Responds to incoming calls and may initiate outgoing calls, providing customer service to plan members, providers and employer groups by answering benefit questions, resolving issues and educating callers. * Verifies enrollment status, makes changes to records, researches and resolves enrollment system rejections; addresses a variety of enrollment questions and/or concerns received by phone or mail. * May be responsible for billing and delinquency processes for assigned groups. * Ensures accuracy and timeliness of the membership and billing function. * Responds to inquiries concerning enrollment processes. * Maintains enrollment database. May order identification cards. * Determines eligibility and applies contract language for each case assigned. * Performs error output resolution for electronic eligibility and processes error discrepancy list. * Bills, collects premiums and reconciles payments. * Maintains and reconciles premium bill, self-bill and individual billed accounts. * Notifies clients of premium discrepancies through payment adjustment notices and detailed audits. * Screens all forms and data for all paperwork received from Sales and/or Underwriting for new group and/or group re-classing benefits. * Makes request to Underwriting, Sales or Brokers for missing information and/or forms needed for new group or re-class of existing group. * May be responsible for loading rates to new groups and renewal/re-class groups within the appropriate system. * Screens group for benefits to determine if existing or new, recognizing when benefits are not standard and handling as appropriate. * Thoroughly documents inquiry outcomes for accurate tracking and analysis. * Develops and maintains positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner. * Performs basic job functions with help from co-workers, specialists and managers on non-basic issues.
Requires a HS diploma or GED; up to 1 year of related experience; or any combination of education and experience, which would provide an equivalent background. EOE.M/F/Disability/Veteran
Job Membership & Enrollment
Title: Membership Representative I - 121845
Requisition ID: 121845