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Representative, Enrollment - Remote, Candidate MUST reside in NY

Molina Healthcare New York; New York Job ID 2022992
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JOB DESCRIPTION

Job Summary

Responsible for preparation, processing and maintenance of new members and re-enrollment. Processes and maintains health plan's member and enrollment records, employer's monthly reports, sending membership cards and materials. Verify enrollment status, make changes to records, research and resolve enrollment system rejections. Address a variety of enrollment questions or concerns received via call tracking, claims, or e-mail. Maintain records in the enrollment database.

KNOWLEDGE/SKILLS/ABILITIES

  • Performs processes to resolve the following eligibility exceptions within the required State/Regulatory timeframes: enrollment file errors, ID card generation errors, PCP assignments and 834 enrollment files to vendor/third party administrators.
  • Process COB eligibility through Molina application to ensure accurate information is represented in Molina's enrollment system.
  • Assists with the support of the newborn enrollment functions, to include call center requests for verification and updates, PCP assignment activity, enrollment record error reports, enrollment/disenrollment activity and Mass Member Moves.
  • Work on claims queue to ensure timely and accurate processing of claims pended due to enrollment or COB related issues.
  • Serves as the Subject Matter Expert (SME) for application data entry to the enrollment process
  • Processes the mail returned by the member providing updates or requested information
  • Processes the mail returned by the USPS for insufficient or inaccurate address; remailing as indicated and reporting inventory as required by department policy
  • Maintains the intake process for department e-mail and distributes as appropriate
  • Works the I Serve process and makes assignments to the vendor and/or Sr. Enrollment Rep as appropriate
  • Works the CMS OEC process, pulling applications from the on-line portal and pushing them through the intake process

JOB QUALIFICATIONS

Required Education

Associate degree or equivalent combination of education and experience

Required Experience

1-3 years

Preferred Education

Bachelor's Degree or equivalent combination of education and experience

Preferred Experience

3-5 years

Pay Range: $12.32 - $24.02 an hour*

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $12.32 - $24.02 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

About Us

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Job Type: Full Time Posting Date: 11/21/2023

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