Member Enrollment Representative

JOB SUMMARY: The Member Enrollment Representative processes manual membership data within our proprietary application. This data is delivered to the company from many sources including: paper enrollment forms, emails, faxes, and spreadsheets. The incumbent ensures turnaround times and quality measures are met or exceeded. Additionally, the representative serves as a direct point of contact for non-electronic groups and their membership data needs. A strong focus on data integrity is required in all aspects of this role. A strong understanding of all business functions and technology processes within the Member Enrollment Department is critical to success in this position.

PRIMARY JOB RESPONSIBILITIES:

• Perform manual data entry and maintenance of membership data.
• Provide superior customer service by serving as point of contact for 'paper' member enrollment groups.
• Be responsive to all client inquiries on membership related issues in a timely and accurate manner.
• Communicate and coordinate eligibility issues with Sales, Client Services, and Customer Service Departments; work collaboratively with these departments to develop solutions.
• Work closely with Sales to identify customer expectations and proactively implement processes and procedures to ensure customer needs are met.
• Maintain on-going knowledge associated with the functionality of the enrollment processing system to make sound decisions that will not adversely impact processes downstream.
• Monitor and access the priority of work in queues and work independently to accomplish daily goals.
• Complete specific assigned queue work and meet or exceed the metrics for accuracy.
• Support Online Enrollment (OE) application by working directly with clients on password resets, site navigation and technical problem solving.
• Support downstream teams by researching and resolving membership that are unable to be processed by the OE system Complete detailed Help Desk tickets as needed to ensure issues are reported and escalated timely.
• Update and track the progress of pending tickets using departmental standard operating procedures.
• Assist in performing audits of data integrity within the claims processing system.
• Deliver quality and accuracy by using the enrollment system to locate records and research data.
• Protect health information (PHI) when handling and processing documents.
• Maintain a safe and clean working environment by complying with procedures, rules, and regulations.
• Other duties as needed or required.

JOB QUALIFICATIONS:

Required:

• High school or equivalent
• 2 years job related experience Perform manual data entry and maintenance of membership data.
• Provide superior customer service by serving as point of contact for 'paper' member enrollment groups.
• Be responsive to all client inquiries on membership related issues in a timely and accurate manner.
• Communicate and coordinate eligibility issues with Sales, Client Services, and Customer Service Departments; work collaboratively with these departments to develop solutions.
• Work closely with Sales to identify customer expectations and proactively implement processes and procedures to ensure customer needs are met.
• Maintain on-going knowledge associated with the functionality of the enrollment processing system to make sound decisions that will not adversely impact processes downstream.
• Monitor and access the priority of work in queues and work independently to accomplish daily goals.
• Complete specific assigned queue work and meet or exceed the metrics for accuracy.
• Support Online Enrollment (OE) application by working directly with clients on password resets, site navigation and technical problem solving.
• Support downstream teams by researching and resolving membership that are unable to be processed by the OE system Complete detailed Help Desk tickets as needed to ensure issues are reported and escalated timely.
• Update and track the progress of pending tickets using departmental standard operating procedures.
• Assist in performing audits of data integrity within the claims processing system.
• Deliver quality and accuracy by using the enrollment system to locate records and research data.
• Protect health information (PHI) when handling and processing documents.
• Maintain a safe and clean working environment by complying with procedures, rules, and regulations.
• Required to attend additional training as requested/deemed necessary.

PHYSICAL DEMANDS: Incumbent must be able to communicate effectively. Requires overall light physical effort (up to 25lbs.) Manual dexterity and sitting is required in carrying out position own position responsibilities (i.e. use of personal computer). Ability to travel or move about within and outside serviced facilities required. Incumbent works primarily in either a private or shared office environment.

Webelieve that everyone should live life free of dental disease. As a purpose-driven, double bottom line company that is improving oral health for everyone, we are transforming the oral health system - from the way we provide care and pay for it, to how we talk about it and prioritize it in our policies and communities.

Meaningful change requires a revolution in oral health. We are redefining what it means to prevent disease and provide better access to care for everyone. We are going beyond the dental chair to reshape the oral health system, addressing total health and the social and cultural factors that impact it.

To make this revolution a reality, we harness our unique reach and insights to advance policy, financing, care, and the community. That means solving problems in a flexible and efficient way, testing and trialing to create new solutions and deliveringmeasurableoutcomes for the people we serve.

The people of DentaQuest have a common purpose, and we work together with passion, perseverance and focus to achieve a nation where no child suffers from the pain of tooth decay. Where adults keep all their teeth for their entire lives. Where every person has access to quality dental care.