Job Title

Responsibilities

Perform eligibility and prescription benefit updates; accurately and professionally resolving issues in real time and providing excellent telephone customer service
Research, update, and follow up on changes such as: enrollment and workflows, eligibility and benefit elections in eligibility system (Vitech), PHI, prescription (Express Scripts), dental and call tracking (QNXT) systems.
Data enter enrollment information, relevant membership data, and supporting documentation obtained from various sources such as: Member Services, Outreach Department, satellite office - pension codes, employer reports, workers compensation, disability, home mortgage, Cross Fund reports, 1199SEIU Training and Employment Funds, GNY Spousal Premiums etc.
Communicate with management; keeping them abreast of any member issues that require escalation and report trends via established protocols.
Create various weekly and monthly Excel reports regarding productivity
Work closely with management in maintaining and reviewing work production
Provide clerical support to the Eligibility department including but not limited to: filing, photocopying, and faxing, etc.
Perform additional duties and projects as assigned by management

Qualifications:

High School Diploma or GED required, some College or Degree preferred
Minimum two (2) years Eligibility systems knowledge/experience (Vitech, QNXT, or ESI) in a health benefits environment required
Minimum two (2) years customer service experience in a call center environment; or two (2) years' experience in a member-facing position required
Comprehensive knowledge of enrollment documentation, eligibility requirements, benefit provisions and enrollment processing required
Excellent keyboarding skills required (minimum 6,000 KPH and 6% or less error rate)
Basic skill level in Microsoft Word and Excel preferred, able to perform enrollment data entry analysis and navigate eligibility systems (Vitech V3)
Excellent customer service and telephone skills a must; able to maintain pleasant and helpful demeanor ensuring professional services are provided
Ability to work well under pressure, multi-task, establish priorities, meet deadlines, problem solve and follow through on assignments
Good communication skills (oral and written) and ability to speak in a clear and concise manner
Available to work overtime preferred
Must meet performance standards including attendance and punctuality

Hotline Support