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Membership Representative I-III - Wallingford, CT; Midland, GA; South Portland, ME; Richmond VA (Office locations) - PS15005 in New Haven, CT at Anthem, Inc.

Date Posted: 12/5/2018

Job Snapshot

  • Employee Type:
    Full-Time
  • Location:
    New Haven, CT
  • Job Type:
  • Experience:
    3 to 5 years
  • Date Posted:
    12/5/2018

Job Description

Your Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care.

This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health benefits companies and a Fortune Top 50 Company.

Membership Representative I/II/III
* Manager will determine level based upon the selected applicant’s skillset relative to the qualifications listed for this position.*

Level I
Responsible for enrollment, billing activities and/or maintaining assigned accounts. Must pass the appropriate pre-employment test battery.  

Primary duties may include, but are not limited to: 
  • Responds to incoming calls and may initiate outgoing calls, providing customer service to plan members, providers and employer groups by answering benefit questions, resolving issues and educating callers. 
  • Verifies enrollment status, makes changes to records, researches and resolves enrollment system rejections; addresses a variety of enrollment questions and/or concerns received by phone or mail. 
  • May be responsible for billing and delinquency processes for assigned groups. 
  • Ensures accuracy and timeliness of the membership and billing function. 
  • Responds to inquiries concerning enrollment processes. 
  • Maintains enrollment database. 
  • May order identification cards. 
  • Determines eligibility and applies contract language for each case assigned. 
  • Performs error output resolution for electronic eligibility and processes error discrepancy list. 
  • Bills, collects premiums and reconciles payments. 
  • Maintains and reconciles premium bill, self-bill and individual billed accounts. 
  • Notifies clients of premium discrepancies through payment adjustment notices and detailed audits. 
  • Makes request to Underwriting, Sales or Brokers for missing information.
  • Thoroughly documents inquiry outcomes for accurate tracking and analysis. 
  • Develops and maintains positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner. 
  • Performs basic job functions with help from co-workers, specialists and managers on non-basic issues.  


Level II
Responsible for enrollment, billing activities and/or maintaining assigned accounts. Must be able to successfully perform all the duties of the Membership Rep I. 

Primary duties may include, but are not limited to: 
  • Responds to incoming calls and may initiate outgoing calls, providing customer service to plan members, providers and employer groups by answering benefit questions, resolving issues and educating callers. 
  • Verifies enrollment status, makes changes to records, researches and resolves enrollment system rejections; addresses a variety of enrollment questions and/or concerns received by phone or mail. 
  • May be responsible for billing and delinquency processes for assigned groups. 
  • Ensures accuracy and timeliness of the membership and billing function. 
  • Responds to inquiries concerning enrollment processes. 
  • Maintains enrollment database. 
  • May order identification cards. 
  • Determines eligibility and applies contract language for each case assigned. 
  • Performs error output resolution for electronic eligibility and processes error discrepancy lists.  
  • Maintains and reconciles premium bill, self-bill and individual billed accounts. 
  • Notifies clients of premium discrepancies through payment adjustment notices and detailed audits. 
  • Makes request to Underwriting, Sales or Brokers for missing information.
  • Thoroughly documents inquiry outcomes for accurate tracking and analysis. 
  • Develops and maintains positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner.


Level III
Responsible for enrollment, billing activities and maintaining assigned accounts. Must be able to successfully perform all the duties of the Membership Rep II. 

Primary duties may include, but are not limited to: 
  • Responds to incoming calls and may initiate outgoing calls, providing customer service to plan members, providers and employer groups by answering benefit questions, resolving issues and educating callers. 
  • Verifies enrollment status, makes changes to records, researches and resolves enrollment system rejections; addresses a variety of enrollment questions or concerns received by phone or mail.
  • Responsible for all billing and delinquency processes for assigned groups.
  • Ensures accuracy and timeliness of the membership and billing function.
  • Responds to inquiries concerning enrollment processes.
  • Maintains enrollment database.
  • Orders Identification Cards. 
  • Determines eligibility and applies contract language for each case assigned. 
  • Performs error output resolution for electronic eligibility and processes error discrepancy list. 
  • Bills, collects premiums and reconciles payments. 
  • Maintains and reconciles premium bill, self-bill and individual billed accounts. 
  • Notifies clients of premium discrepancies through payment adjustment notices and detailed audits.  
  • Fully proficient in all key areas; performs most complex work. 


Requirements
Membership Representative I/II/III


Level I
  • High School diploma or GED; 
  • up to 1 year of related experience; or any combination of education and experience, which would provide an equivalent background.
  • Working knowledge of Microsoft Excel, Outlook and Word is preferred. 
  • ACES E&B experience is preferred. 


Level II
  • High School diploma or GED; 
  • 1-3 years relevant healthcare customer servicing experience which includes at least 1 year company membership experience; or any combination of education and experience, which would provide an equivalent background.
  • Working knowledge of Microsoft Excel, Outlook and Word is preferred. 
  • ACES E&B experience is preferred. 


Level III
  • High School diploma or GED; 
  • 3-5 years relevant membership experience which includes at least 2 years of company membership experience; or any combination of education and experience, which would provide an equivalent background.
  • Working knowledge of Microsoft Excel, Outlook and Word is preferred. 
  • . ACES E&B experience is preferred. 


Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2017 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at antheminc.com/careers. AnEqualOpportunityEmployer/Disability/Veteran

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