Overview

Enrollment Processor Job at Blue Cross Blue Shield of Massachusetts – 4.0 in Hingham, MA

Job Description

Ready to help us transform healthcare? Bring your true colors to blue.


The Enrollment Processor is responsible for processing member applications and enrollment transactions accurately and in compliance with the Center for Medicare and Medicaid Services. Utilize strong research skills to identify and resolve member escalated issues.

Key Accountabilities:
Download and process enrollment files and paper applications, ensure applications are processed accurately and timely

Contact members telephonically to obtain any missing information to complete their enrollment applications

Update member records; including address changes, bill option changes and plan changes

Analyze enrollment error reports, identify trends and report to leadership

Process enrollment queues in the membership system; ensure data integrity across all systems

Create and maintain enrollment processing policies and procedures and workflows

Cross train to support: Process Control and assist during vacancies and high inventory periods, LEP review and submission, work items and applications, and other functions as identified

Contribute toward achieving Medicare Markets goals including STARS, SQM and CAHPS and demonstrate complete, accurate and timely enrollment processing

Perform daily review of our vendor letters to ensure letters are accurate and appropriate

Provide outstanding level of service to both internal and external customers by supporting the MAPD Enrollment Helpdesk to help achieve first call resolution

Work on various projects relating to Medex and Medicare Advantage such as audits and monthly reporting

Help to resolve Medex pending applications to complete member enrollment applications

Other responsibilities as identified by Leaders

Work well in a team environment and keep communication lines open with leaders and peers

Qualifications (Knowledge, skills, and abilities)

Strong written and verbal communication skills

Ability to work closely/successfully in a team environment

Ability to work additional hours during peak inventory periods (during Open Enrollment from October – March)

Demonstrate flexibility and willingness to be cross trained to support other job functions to ensure business unit success

Excellent time management and organizational skills; strong attention to detail

Knowledge of Medicare Advantage/CMS Chapter regulations preferred

Ability to work in fast-paced, deadline-driven dynamic environment

High degree of initiative; decision-making skills

Knowledge of customer service environment, including BSC, TPS, RTMS, and NASCO preferred

Education/Relevant Experience:
Bachelor’s degree or equivalent work experience preferred.

Minimum Education Requirements:
High school degree or equivalent required

Location Hingham Time Type Full time

About Company

Company: Blue Cross Blue Shield of Massachusetts – 4.0

Company Location:  Hingham, MA

About Blue Cross Blue Shield of Massachusetts - 4.0