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University of Utah Health Insurance Enrollment Specialist I in Murray, Utah

Overview

As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. University of Utah Health seeks staff that are committed to the values of compassion, collaboration, innovation, responsibility, diversity, integrity, quality and trust that are integral to our mission. EO/AA

This position for use in Health Plans Departments only. This position is respons

ible for updating and maintaining eligibility/enrollment and premium billing information; will also update files and resolve other issues related to insurance eligibility/enrollment and/or premiums.

This position will track member enrollment from start to finish, data entering member information into Salesforce (customer relationship management software), MedMC (claims), and CareRadius (patient mangement software). Will also be responsible for submitting files through CMS software, and to follow up with brokers on incomplete enrollment applications.

This position will also analyze data requests and data reports for accuracy; and transmit files to and from shared drives and vendor SFTP sites on a regular basis.

Due to all the data processing, a technical aptitude is required in this position, including strong Microsoft Excel skills and experience. Microsoft Access and Microsoft SQL is also preferred, but not required.

Responsibilities

  • Processes and maintains manual and electronic enrollment information.

  • Coordinates electronic enrollment processes and works with the EDI team to ensure accuracy and timely processing of all variations of files related to enrollment.

  • Responsible for examination and responses pertaining to escalated federal and state appeals process dealing with enrollment and premium billing.

  • Adheres to and exceeds department quality and production processing standards.

  • Processes and researches premium invoicing for all lines of business.

  • Coordinates with Finance department to maintain financial accuracy of premium and enrollment data.

Knowledge / Skills / Abilities

  • Demonstrated potential ability to perform the essential functions as outlined above.

  • Knowledge of Medicaid, Commercial insurance, Medicare and benefits.

  • Demonstrated proficiency using Microsoft Office.

  • Strong written and verbal communication skills.

  • Detailed knowledge of insurance industry, policy and procedures, eligibility, premiums and COB/claims processing laws, rules and regulations.

Qualifications

Qualifications Required

  • Associate's degree or two years of relevant experience in insurance, enrollment, eligibility, premium billing, medical claims processing, or benefits enrollment processing.

Qualifications (Preferred)

Preferred

  • Microsoft Excel, Microsoft Access, Microsoft SQL.

  • Salesforce experience.

  • Medicare enrollment experience.

Working Conditions and Physical Demands

Employee must be able to meet the following requirements with or without an accommodation.

  • This is a sedentary position in an office setting that may exert up to 10 pounds and may lift, carry, push, pull or otherwise move objects. This position involves sitting most of the time and is not exposed to adverse environmental conditions.

Physical Requirements

Non Indicated

EEO Statement

The University of Utah Health Care is an Affirmative Action/Equal Opportunity employer. Upon request, reasonable accommodations in the application process will be provided to individuals with disabilities. The University of Utah Health Care is committed to diversity in its workforce. Women and minorities are encouraged to apply.

Requisition Number 44892
Reg/Temp Regular
Employment Type Full-Time
Shift Day
Work Schedule 8 to 5
Location Name University of Utah Health Plans
Patient Care? No
City Murray
State UT
Department UIP CST 01H Program Services
Category Insurance / Health Plans

The University of Utah Health Care is an Affirmative Action/Equal Opportunity employer. Upon request, reasonable accommodations in the application process will be provided to individuals with disabilities. The University of Utah Health Care is committed to diversity in its workforce. Women and minorities are encouraged to apply.

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