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Membership Representative I/II/III

Company: Anthem, Inc
Location: La Mirada
Posted on: November 22, 2021

Job Description:

Description SHIFT: Day JobSCHEDULE: Full-timeYour Talent. Our Vision. At Anthem, Inc., its a powerful combination, and the foundation upon which were creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care.This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health care companies and a Fortune Top 50 Company.The Membership Representative I/II/III is responsible for enrollment, billing activities and/or maintaining assigned accounts. Must be able to successfully perform all the duties of the Membership Rep I.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 lists.
  • 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 for 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.Qualifications
    • Requires H.S. diploma or GED.
    • A minimum of 1 year relevant healthcare customer servicing experience which includes a minimum of 1 year membership experience with the company; or any combination of education and experience which would provide an equivalent background.We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Anthem, Inc. has been named as a Fortune 100 Best Companies to Work For, is ranked as one of the 2020 Worlds Most Admired Companies among health insurers by Fortune magazine, and a 2020 Americas Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions. REQNUMBER: PS60657-California

Keywords: Anthem, Inc, La Mirada , Membership Representative I/II/III, Other , La Mirada, California

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