Enrollment Auditor 1 in Meridian, ID at Volt

Date Posted: 8/18/2019

Job Snapshot

Job Description

POSITION PURPOSE:

To establish and maintain enrollment and accounts receivable records for group or individual accounts. Communicate with group representatives, members and applicants regarding enrollment and billing inquiries.

MINIMUM POSITION REQUIREMENTS:

Required Experience:

  • Six months enrollment and billing in a health insurance industry; or
  • One year general office

Required Knowledge, Skills and Abilities (KSAs):

Skills:

  • Personal computer
  • Microsoft Word - Basic
  • Microsoft Excel - Basic
  • Verbal, written and interpersonal communication
  • Problem-solving
  • Typing (30 words per minute)
  • Ten-key (75 key strokes per minute)

PREFERRED QUALIFICATIONS:

  • Medical billing or health insurance industry experience
  • Accounting, reconciliation or bookkeeping experience
  • Knowledge of the Health Insurance Portability and Accountability Act of 1996 (HIPAA)
  • Knowledge of the Consolidated Omnibus Budget Reconciliation Act of 1986 (COBRA)
  • Knowledge of the Employee Retirement Income Security Act of 1974 (ERISA)
  • Knowledge of Facets and other Blue Cross of Idaho specific software programs

PRIMARY ACCOUNTABILITIES: 

  1. Process membership activity by establishing records, changing, coding and entering data of multiple types of Blue Cross group or Individual accounts.  Review applications for completeness and maintain proper administration of underwriting regulations on eligibility and acceptance of premiums.

  1. Assure prompt, complete and accurate reconciliation of daily income by researching and adjusting membership records and reconciling paid bills/coupons.  Send correspondence and collect premiums on delinquent accounts.  Maintain eligibility and billing on the Facets system.

  1. Receive, research and reply to telephone, written and electronic inquiries, related to enrollment and billing, within corporate and departmental guidelines for timeliness and accuracy in a courteous and professional manner.  Track all appropriate inquiry information into the applicable corporate system.

  1. Report changes and/or problems to management, district offices and other areas as necessary.  Monitor and update time allocations as applicable.

  1. Maintain knowledge of federal regulations relative to Enrollment and Billing activities including, but not limited to the following: HIPAA, COBRA and ERISA.

  1. Assure all documents are properly coded and prepared for the Image/Archive System.

SECONDARY ACCOUNTABILITIES:

  1. Maintain knowledge of CVS and Vision Service Plan (VSP) systems to ensure accurate enrollment.

  1. Perform back-up coverage throughout the area as requested by the Supervisor.

  1. Perform other duties as requested by the Supervisor.