Responsible for determining eligibility which includes reviewing and calculating taxes, payroll stubs, etc. according to state or federal guidelines. It also includes processing member enrollment applications, recertifications, changes and terminations complying with government regulations and timeframes. Works directly with customer walk-ins to assist them with completing their applications, calculate pertinent information to determine eligibility or billing related changes. Handle customer service events, written correspondence, or billing related questions in accordance to government regulations.
Associates Degree preferred.
Minimum of 2 year employment experience in a health insurance setting preferred; 1 year experience in Government Programs preferred.
Ability to interpret and make decisions based on corporate underwriting guidelines, as well as State of New York & Federal statutes relating to healthcare administration.
Demonstrated ability to identify, analyze and solve problems.
Demonstrated ability to effectively communicate with external and internal contacts both verbally and via written correspondence.
Strong system research and analysis skills; deductive and creative thinking. Strong attention to detail and capability to meet established productivity and quality standards.
Ability to effectively manage time with multiple task assignments.
Salary Grade: 13