Customer Service Representative I – Medicaid Enrollment

🔥 5 minutes ago

🔔 Pennsylvania – Remote

🔔 Pennsylvania – Remote

⏰ Full Time

🟢 Junior

💝 Customer Support

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 10%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Geisinger

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1915

🏥 Healthcare

💊 Pharmaceuticals

🧘 Wellness

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.

📋 Description

• Resolve and reconcile enrollment reports and eligibility issues according to policy, procedure, and state coverage guidelines • Initiate communication and literature for newly enrolled health plan members, dependents, and employer groups • Interpret and apply rules and regulations in contractual agreements with employer groups and vendors • Perform membership data extraction reports for employer group audits and compliance with performance risk guarantee commitments • Update, approve, and interpret membership data and workflows in employer group online software modules • Determine member eligibility and process terminations and disenrollments • Prepare, generate, and distribute enrollment-related letters to subscribers and members • Determine whether services are covered benefits based on line of business and product design • Review suspended claims and resolve them using applicable policies, procedures, and product benefits • Provide team-building resources and direct peers to appropriate claims resolution policies and procedures • Provide daily support and advice to member and provider services staff regarding claims issues • Research claim issues from participating providers and identify criteria for payment reconsideration • Resolve customer concerns, provide education and instruction, and maintain customer satisfaction • Participate in cross-training and improve processes within the Customer Service team

🎯 Requirements

• High School Diploma or Equivalent (GED) (Required) • Minimum of 1 year of customer service experience (Required) • Communication skills • Customer retention skills • Customer service skills • Resident in the Eastern Standard Time Zone • Ability to work 40 scheduled hours per week • Must comply with organization policies and procedures

🏖️ Benefits

• Healthcare benefits for full-time and part-time positions from day one • Vision coverage • Dental coverage • Domestic partner benefits • Atmosphere of collaboration, cooperation and collegiality