Enrollment Representative (Remote - Ca)

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Our mission is to make healthcare right. Together. We are a value-driven healthcare company committed to providing personalized care to aging and underserved populations. We do this by aligning stakeholders across the healthcare ecosystem. Together, we can improve consumer experience, optimize clinical outcomes, and reduce total cost of care.

What drives our mission? The company values we live and breathe every day. We keep it simple: Be Brave. Be Brilliant. Be Accountable. Be Inclusive. Be Collaborative.

If you share our passion for changing healthcare so all people can live healthy, brighter lives – apply to join our team.

Our Enrollment Representatives facilitate the processing, coordination, and handling of all Medicare enrollment and disenrollment functions in a timely and accurate manner with internal departments and CMS; provide general assistance to Member Services Department

This position is 100% remote but candidates must reside in Southern California.

Role Responsibilities

• Generate submission report and upload enrollment application to member profile on a daily basis
• Process enrollment applications: Data entry of prospective member into enrollment system for completed enrollments that have been evaluated with an assigned election type/code.
• Screen all incoming application and follow up with broker for all discrepancies / missing information to ensure application is complete.
• Verify and print beneficiary eligibility evidence for Part A/B, Medi-cal and Wipro (infocrossing)
• Handle and process all member enrollment, disenrollment, and cancellation requests; Duties include but not limited to:
• Conduct any necessary research on questionable applications by working with supervisory staff.
• May receive transferred calls from Member Services Department and/or other departments. Inform Supervisor / Manager of issues encountered and provide resolution in a timely manner
• Date stamp, sort and combine application with eligibility into PDF packets. (Manage each application with its down individual folders for back up)
• Outbound calls to members for research or obtaining additional information
• Follow defined work schedule. Be ready to handle outbound customer calls and assignments in a professional manner; must follow company and department guidelines for all time off/vacation/overtime requests, especially during enrollment season; Work on assigned/required weekends and after hours during open enrollment season.
• Participating in Team chats, emails and meetings related to Department operations
• Assist in translation and proofreading upon request from upper management and the marketing department.
• Notify Broker Relations Department when questionable or non-compliant pattern is identified with specific brokers.
• Verification of member with Medi-Cal eligibility through online verification for DSNP/CSNP monthly process
• PDF all incoming applications and disenrollments from email Inbox fax or electronic enrollment via enrollment site, or OEC (mailed in (scan), emailed in)
• Key application into Enrollment system for tracking and confirmation purposes
• Coordinate with Marketing Department to properly track the mailing of ID cards, and all other applicable letter/notices to members after enrollment completion
• Print auto-generated notices (OEV, DIS, REJ, CAN, RFI etc.). Upload, call log and mail out.

Education, Training, And Professional Experience

• One (1) to three (3) years of health plan or clerical experience required.
• Bilingual in Spanish preferred
• High School diploma or GED required.
• Previous knowledge and/or experience working with Managed Care, and/or Medicare Advantage required.
• Previous experience in customer service

PROFESSIONAL COMPETENCIES

• Organized and be able to prioritize work to meet deadlines
• Must display active listening skills
• Must present strong ability to read and comprehend material presented both orally and in writing
• Understanding of regulatory and compliance rules surrounding enrollment and eligibility
• Strong communication skills, both verbal and written (bilingual is a plus, but not required)
• Must be detailed oriented and present critical analytical thinking skills
• Must be flexible to change and open to learning new tasks as assigned
• Able to thrive and adapt in a fast paced, stressful environment
• Works independently with little supervision
• Must have experience using Microsoft Office, along with general typing skills

WORK ENVIRONMENT

In normal circumstances, the majority of work responsibilities are performed in a home office or open office setting, carrying out detailed work as assigned, sitting in a workspace, and working with a computer or other office equipment. Must be required to be able to sit for approximately 70% daily. Some travel may be required.

For individuals assigned to a location(s) in California, Bright Health is required by law to include a reasonable estimate of the compensation range for this position. Actual compensation will vary based on the applicant's education, experience, skills, and abilities, as well as internal equity. A reasonable estimate of the range is $17.13-$23 Hourly.

Additionally, employees are eligible for health benefits; life and disability benefits, a 401(k) savings plan with match; up to 21 days of PTO, 10 paid holidays, plus 2 floating holidays per year; and a lifestyle spending account.

As an Equal Opportunity Employer, we welcome and employ a diverse employee group committed to meeting the needs of Bright Health, our consumers, and the communities we serve. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.