Send written correspondence and communicate with clients via phone to obtain, review and process enrollment materials for participants of CaliforniaChoice.
Expert knowledge of all MPC Enrollment Rep I duties.
Demonstrate knowledge of Correspondence duties as determined by department assessment.
Understand company policies and procedures as they apply to CaliforniaChoice plans.
Responsible for the review and processing of the following forms including but not limited to:
Employee Applications
Change Request Forms
Employee Termination Forms
Web Based Forms
Identify and obtain missing/incomplete information on forms based on guidelines and standard operating procedures.
Follow the department Pending Item process.
Compose clear and concise written correspondence (i.e. pending item requests, denials, confirmations, memos, letters, etc.).
Place outbound calls to obtain missing/incomplete information on forms.
Maintain working knowledge of all products and systems used for job function (i.e. Pegasus, doc-link, SharePoint, etc.).
Enter appropriate comments in a clear and succinct manner into Pegasus and/or Doc-Link.
Meet department standards for quality and quantity of work.
Maintain department and team standards for turnaround times.
Adhere to all PHI (Personal Health Information) guidelines.
Assist with departmental training needs as needed.
Onsite or remote regular attendance and punctuality are essential functions of the job.
Performs other business tasks or functions as assigned.
Qualifications
Customer Service and phone etiquette experience a must.
Strong communication skills (written, grammatical and verbal) required.
Must be able to communicate effectively in English.
Ability to interact and communicate effectively with all levels of employees and customers.
Must have strong attention to detail.
Strong analytical skills and problem solving skills.
Ability to perform in a fast-paced, deadline-oriented work environment.
Excellent customer service and organizational skills.
Able to build/gain commitment and overcome resistance to change.
Ability to retain large quantities of information.
Accurately type a minimum of 50 WPM.
Proficient with Microsoft Office software (Access, Word, Excel, PowerPoint, Visio, Publisher, SharePoint, Outlook), web based technology.
Must be highly motivated, have ability to take initiative, be accountable, have excellent interpersonal, and service oriented skills.
Knowledge of the healthcare insurance industry a plus.
Requirements
High School Diploma or equivalent required.
Three plus (3+) years of office and/or customer service experience required.
At least one (1) year of data entry experience.
Physical Requirements
Must be able to sit for extended periods of time with occasional standing and walking.
Must have adequate hearing for phone work.
Vision requirements include close vision and the ability to adjust focus.
Must be able to use a keyboard and other office equipment.