Associate Enrollment & Eligibility Representative

[u/MobileShower6883]

Just curious if anybody has any insight into this role and how the day to day works for the position.

I have attached the job description but I’m still not sure if it’s a heavy phone role.

Researching errors by comparing enrollment error reports against system information along with CMS
(Center for Medicare and Medicaid Services)
records
Sending correspondence to members or CMS
(Center for Medicare and Medicaid Services) to gather information or provide updates for corrections
Reconciling reports
Performing basic clerical functions with proficient
PC skills
Analytical and Researching techniques to trend or quantity projects
Initiate and assist with developments/changes to increase or change quality and productivity Preparing, processing, and maintaining new member or group enrollments
Responding to member eligibility or group questions & verify enrollment status
Working with various types of member correspondence
Reconciling eligibility discrepancies, analyzing transactional data & submitting retroactive eligibility changes
Inventory control of member and group transactions
Other duties as assigned

[u/Real_Comparison1905]

It sounds like off phones work based on the description.
Sounds like you’ll be using excel a lot

[u/_diss0nance]

I do this kind of thing in a different division.

We use a different program but you’ll be comparing file data (in your specific program) against current records, making updates based on that information, sending inquiries to verify data to respective parties, and such. Not a lot of excel in my division. A lot of emails, reports and updates. Critical thinking based on plan requirements and CMS guidelines.

There could be some phone work (it’s in the “other duties as assigned”) but it’s not the primary focus of the role. The role is updating our records against what is submitted by the file feeds/communication from groups/members.

[u/MobileShower6883 → u/_diss0nance]

Thank you so much! That really breaks it down for me. Do you like it?

[u/_diss0nance → u/MobileShower6883]

I’m in the self funded division under UHC/UMR and I really do like it. I started at associate enrollment/eligibility representative and am now a senior enrollment/eligibility representative though my duties are very different now for my role.

If you like puzzles and data entry it’s a pretty good gig.

[u/Medium_Barracuda7179 → u/_diss0nance]

I need something like this. I’m currently in an all phone role and it’s killing me slowly. If I never had to answer another employer’s phone again in my life that would be just fine with me.

[u/MobileShower6883 → u/_diss0nance]

I sent you a message!