**NO EXPERIENCE NECESSARY- WE WILL TRAIN**
Do you want a career where you can make a difference? Allegiance is a growing company with hometown values that is looking for dynamic candidates to join the team! A positive, team-oriented environment is provided with opportunities for advancement.
Allegiance offers full-time positions with evenings, weekends, and holidays off and a multi-faceted benefits package.
We pride ourselves in having a reputation for top-notch customer service. Make a difference. Start your career with Allegiance today!
REPORTS TO: Enrollment Services Team Leader
LOCATION: Allegiance office or off-site
FLSA STATUS: Non-Exempt
POSITION RESPONSIBILITIES:
The Enrollment Specialist is responsible for maintaining accurate and complete eligibility information electronically and manually. The incumbent interprets group summary plan descriptions to assist plan participants and client contacts on all issues related to eligibility.
The incumbent is expected to communicate professionally with peers, supervisors, subordinates, vendors, customers, and the public, and to be respectful and courteous in the conduct of this position.
ESSENTIAL JOB FUNCTIONS:
Essential job functions include the following. Other functions may be assigned as business conditions change.
- Enrolls plan participants in the claims processing system and updates the records as needed; requests additional information from client when needed.
- Request employee verification and eligibility forms from Employers for Risk Management and Stop Loss coordination as needed.
- Coordinates new employee and status change information with the ID Card Coordinator.
- Maintains all participant status information in enrollment logs as needed.
- Notify claims examiner and/or pharmacy team of claims incurred after termination to request refunds if needed.
- Notify COBRA Specialist of COBRA Qualifying Events for members.
- Maintain COBRA fields for outside COBRA vendors when needed.
- Answers telephone calls and assist with participants eligibility requests; documents conversations in Chronolog
- Run monthly reports to determine if members turn max age or require changes to eligibility.
- Maintains enrollment records as needed for documentation retrieval.
- Utilize reference materials within department and company or as necessary to guide in decision making process.
- Coordinates with others in department and in Company to manage fluctuating work load by assisting others or requesting assistance as needed.
- Coordinates legal issues with compliance officer to provide answers to clients and participants.
- Makes proper decisions regarding eligibility as dictated by group. Knows when to attempt resolution of problems independently and when to seek assistance from Team Leader and Department Manager or other appropriate resource.
- Meets or exceeds company standards for production and quality.
- Contributes to the daily workflow with regular and punctual attendance.
NON-ESSENTIAL JOB FUNCTIONS:
Performs related or other assigned duties as required or directed
SUPERVISION EXERCISED:
None.
PHYSICAL WORKING CONDITIONS:
Physical requirements are representative of those that must be met to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Sitting 90%
Bending Some
Kneeling Some
Computer Screen High (visual acuity corrected to 20/30)
Lifting up to 40 lbs.
Walking 5%
Telephone Yes
Standing 5%
Manual Dexterity Medium
Reaching Some
JOB SPECIFICATIONS:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Minimum Education: High school graduation or GED required.
Certification(s) Required: None.
Minimum Experience: Experience with computers and customer service required.
Other Qualifications:
▪ Excellent oral and written communication skills required.
▪ PC skills, including Windows, Word and Excel. Must be able to adapt to software changes as they occur.
▪ Ability to learn all functions of the claims processing software program as is necessary for enrollment functions and adapt to software changes as they occur.
▪ Knowledge of the laws governing the Consolidated Omnibus Budget Reconciliation Act of 1985.
▪ Knowledge of the laws governing the Health Insurance Portability and Accountability Act of 1996.
▪ Ability to enter data with accuracy and precision.
▪ High level of interpersonal skills to work effectively with others.
▪ Ability to organize and recall large amounts of information including interactions with employees, agents, plan participants and clients.
▪ Ability to read, analyze and interpret benefit summary plan descriptions, insurance documents and regulations.
▪ Ability to project a professional image and positive attitude in any work environment.
▪ Ability to comply with privacy and confidentiality standards.
▪ Ability to analyze and solve problems with professionalism and patience, and to exercise good judgment when making decisions.
▪ Ability to operate typical office equipment.
▪ Working knowledge of general office procedures.
The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel as classified.
*Allegiance Benefit Plan Management, INC is an Equal Opportunity Employer. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.
If you require reasonable accommodation in completing the online application process, please email: recruiting@askallegiance.com for support.
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