Customer Service Representative (Contract)

JP43209

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.

We are looking for contract workers (via BCforward) who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

Responsible for enrollment, billing activities and/or maintaining assigned accounts. Expected to perform basic job functions with help from co-workers, specialists and managers on non-basic issues.

Primary duties may include, but are not limited to:

• May be responsible for loading rates to new groups and renewal/re-class groups within the appropriate system.
• Performs basic job functions with help from co-workers, specialists and managers on non-basic issues.
• Screens group for benefits to determine if existing or new, recognizing when benefits are not standard and handling as appropriate.
• May be responsible for billing and delinquency processes for assigned groups.
• Makes request to Underwriting, Sales or Brokers for missing information and/or forms needed for new group or re-class of existing group.
• 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.
• Must maintain 48 hour TAT on emails within 90 days of completing training
• Handles basic Medical Evidence Underwriting
• Maintains and reconciles premium bill, self-bill and individual billed accounts.
• 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.
• Must be able to Consistently average 98% quality on phone and enrollment audits within 90 days of completing training
• Maintains enrollment database.
• Determines eligibility and applies contract language for each case assigned.
• Addresses a variety of enrollment questions and/or concerns received by phone or mail.
• Screens all forms and data for all paperwork received from Sales and/or Underwriting for new group and/or group re-classing benefits.
• Responds to inquiries concerning enrollment processes.
• Ensures accuracy and timeliness of the membership and billing function.
• Bills, collects premiums and reconciles payments.
• Thoroughly documents inquiry outcomes for accurate tracking and analysis.
• Verifies enrollment status, makes changes to records, researches and resolves enrollment system rejections;
• May order identification cards.
• Performs error output resolution for electronic eligibility and processes error discrepancy list.
• Notifies clients of premium discrepancies through payment adjustment notices and detailed audits.

Requirements:

• Knowledge of Live and Disability Insurance preferred but not required.
• Requires a HS diploma or GED; or any combination of education and experience which would provide an equivalent background.
• Company systems knowledge preferred.

Additional Details:

• Remote, can be located anywhere in the US.
• Monday through Friday, 8am to 5pm in candidates local time zone, but training is 3 weeks and will be 8am- 5pm eastern time.
• Attendance policy: temps are permitted no more than 3 days missed in training and no more than 9 unscheduled in a rolling 12 months.
• Temp with possibility of permanent employment.
• Must adhere to Attendance Policy and all other company policies and guidelines.

BCForward is An Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability.

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