Customer Service Representative I – Enrollment

Yesterday

🔔 Pennsylvania – Remote

Although this job is listed in Pennsylvania, this company may be open to hiring remote in other states.

⏰ Full Time

🟢 Junior

💝 Customer Support

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

Apply Now

Receive Emails with Similar Jobs

Geisinger

WebsiteLinkedInAll Job Openings

Healthcare • Pharmaceuticals • Wellness

Geisinger is a healthcare organization that has been providing accessible medical services for over a century in Pennsylvania. It focuses on meeting the healthcare needs of its communities and is dedicated to innovative patient care. With career opportunities in various fields including nursing, allied health, and administration, Geisinger promotes professional development and a supportive workplace for its employees, emphasizing diversity, equity, and inclusion.

10,000+ employees

Founded 1915

💊 Pharmaceuticals

🧘 Wellness

📋 Description

• Assists in resolving customer concerns, providing appropriate education/instruction and maintaining customer satisfaction by providing the highest level of customer service. • Resolves and reconciles enrollment reports and all related eligibility issues by following policy and procedure as well as any state legislated coverage and eligibility guidelines. • Initiates communication and literature to the newly enrolled Health Plan member, dependents and employer groups. • Interprets and appropriately applies rules and regulations in contractual agreements and with employer groups and vendors. • Performs membership data extract reports and supplies them to employer groups as an audit tool for accuracy and compliance with performance risk guarantee commitments. • Updates, approves and interprets membership data and workflow produced by online software capabilities in employer group modules. • Determines the eligibility of most members as well as processing terminations and disenrollments. • Prepares, generates and appropriately disseminates letter communications to subscribers and members with regard to enrollment activity. • Determines if services received are covered benefits as applicable by line of business and product design. • Reviews suspended claims for resolution by applying current policies, procedures and benefits applicable to specific products. • Provides team building resources to assist in directing peers to proper claims resolution policies and procedures in order to assist members and providers. • Provides daily support and advice to member and provider services staff regarding claims issues. • Researches claim issues from participating providers and identifies specific criteria for reconsideration for payment.

🎯 Requirements

• High School Diploma or Equivalent (GED)- (Required) • Minimum of 1 year-Customer Service (Required) • Skills: Communication, Customer Retentions, Customer Service

🏖️ Benefits

• healthcare benefits for full time and part time positions from day one • vision • dental • benefits for domestic partners • atmosphere of collaboration, cooperation and collegiality