Enrollment and Billing Representative
Dean Health Service Company, LLC

Madison, Wisconsin

This job has expired.


It's more than a career, it's a calling.
WI-Dean Health Plan 1277 Deming

Worker Type:
Regular

Job Summary:
Determines applicant eligibility for enrollment and continuation or extension of coverage in accordance with contracts, member certificate, and other regulatory entities. Provides eligibility information and acts as a liaison for enrollment and eligibility issues. Reconciles enrollment related discrepancies.

Job Responsibilities and Requirements:

PRIMARY RESPONSIBILITIES

  • Reviews enrollment applications to determine initial and ongoing eligibility of individuals for coverage according to applicable contracts.
  • Processes quality assurance and error reports to ensure appropriate coverage for members.
  • Prepares and adjudicates member and group accounts for billing; and prepares statements on a monthly and quarterly basis.
  • Identifies and escalates problems and opportunities to the manager.
  • Maintains compliance with internal and regulatory standards.
  • Initiates billing and enrollment adjustments and coordinates reconciliation of billing problems with accounts receivable staff.
  • Answers and assists customer matters with internal departments and external groups.
  • Provides back-up support to the enrollment and billing staff as needed.
  • Performs other duties as assigned.

EDUCATION
  • High school diploma or equivalent

EXPERIENCE
  • Two years' experience

PHYSICAL REQUIREMENTS
  • Frequent lifting/carrying and pushing/pulling objects weighing 0-25 lbs.
  • Frequent sitting, standing, walking, reaching and repetitive foot/leg and hand/arm movements.
  • Frequent use of vision and depth perception for distances near (20 inches or less) and far (20 feet or more) and to identify and distinguish colors.
  • Frequent use of hearing and speech to share information through oral communication. Ability to hear alarms, malfunctioning machinery, etc.
  • Frequent keyboard use/data entry.
  • Occasional bending, stooping, kneeling, squatting, twisting and gripping.
  • Occasional lifting/carrying and pushing/pulling objects weighing 25-50 lbs.
  • Rare climbing.

Work Shift:
Day Shift (United States of America)

Job Type:

Employee

Department:
97230188 700445-Enrollment and Billing

Scheduled Weekly Hours:
40

SSM Health complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex.

Learn more here


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