Sr. Membership Rep
EmblemHealth - New York, NY

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Internal Applicants must obtain a JOB POSTING INFORMATION SHEET from the HR Department to find out when the BRIEFING and TEST(S) are scheduled.

  • Respond to inquiries as needed, relating to group contracts, Group Master File updates, billing premium and membership reconciliations.
  • Process enrollments, terminations, reinstatements and changes from paper to electronic transmissions on Q-CARE and DB2.
  • Communicate with groups and internal personnel in response to telephone and written inquiries regarding enrollment and billing issues. If necessary visit with the client, Broker or Group.
  • Process all enrollment transactions to include terminations, reinstatements.
  • Process and respond to phone and written inquiries from General Agents, group owners and brokers concerning billing, commissions, plan changes, renewals, reinstatements and other broker related business issues.
  • Process electronic enrollment files to include EMIS, Excel EMIS
  • Ensure the unit complies with SOX and SAS 70 controls and processes.
  • Prepare professional documents (letters, bills, spreadsheets) for presentation to accounts upon request, including business correspondence to General Agents and brokers as directed by department manager or director.
  • Perform related clerical duties as required.
  • Two (2) years of college or equivalent business experience with knowledge of EmblemHealth Membership Billing policies and procedures required.
  • PC knowledge required with demonstrated proficiency in Microsoft Word, Excel and Access.
  • Ability to act as a liaison between groups and various internal departments to ensure resolution of inquiries.
  • Ability to understand and use good business judgment when applying established procedures and policies.
Test Subjects:
Microsoft Word, Excel and Access
Verbal Presentation
  • Must pass the computer skills assessment test in order to take the written exam
  • Must pass written exam in order to attend Verbal Presentation
  • Interview will be conducted with those who qualify
Salary Range: $764.98 to $1312.31 per week