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   Current UPMC employees must apply in HR Direct

Enrollment Specialist I - Temporary

Description

Do you have a strong customer service background and the ability to think analytically? If so, an opportunity as a temporary Enrollment Specialist I with UPMC's Health Plan's Commercial Enrollment team may be the perfect fit for you! 


We are currently hiring for temporary roles in the US Steel Tower in downtown Pittsburgh. Our temporary employees receive a competitive pay rate of $15 per hour and opportunities to move from a temporary position to a permanent role. Our standard operating hours are standard daylight hours, Monday - Friday. 

The Enrollment Specialist will be responsible for the creation and maintenance of eligibility in the transactional system, responding to both internal and external customer inquiries, and resolving issues to meet or exceed service requirements. To successfully perform in this role, an Enrollment Specialist must have a comprehensive understanding of enrollment regulations and complete all duties with strict regard to policies and procedures. This includes performing duties related to the processing and maintenance of all member requested transactions, include generation of required letters to ensure enrollment and/or disenrollment processes are completed compliantly. 

Responsibilities:

  • Ability to analyze information to make appropriate decisions regarding enrollment/disenrollment, complying with applicable regulations and governance.
  • Ability to make eligibility determinations based on CMS (Part A/Part B Eligibility), DPW (Medical Assistance Eligibility), and/or PID requirements, in accordance with the application election period guidelines. Ability to accurately identify appropriate election period based upon analysis of beneficiary/member history and regulatory guidance.
  • Comprehension and application of eligibility regulations to process enrollment transactions and generation of corresponding letters to members. Must keep up to date with new regulations and guidance.
  • Daily clerical responsibilities related to processing and electronic storage of member correspondence.
  • Identify areas of concern or trends that may compromise client satisfaction or compliance with government regulations.
  • Initiation and generate of appropriate correspondence based on type of transaction processed, includes initiation of outreach requests and written correspondence (letters), as necessary.
  • Interact with Sales staff to ensure all required date elements for completed application are received and any issues are addressed timely, in accordance with compliance requirements.
  • Maintain employee/insured confidentiality.
  • Process all types of enrollment and disenrollment transactions in accordance with company policies and procedures in a timely manner while meeting production and quality goals.
  • Support team projects within Enrollment Services; other projects as assigned.
  • Understanding of varied and detailed enrollment and disenrollment requirements and processing rules based upon the product (HMO, PPO, EPO, SNP, PDP, Select, Supplemental, or National Complimentary) and Individual vs. Employer Group, including, but not limited to, understanding and application of service areas by product. 

Qualifications

  • High school graduate or equivalent required, college degree preferred. 
  • Minimum of six months of customer service and/or call center experience preferred. 
  • Ability to interpret and apply complex eligibility regulations as mandated by CMS, DPW, and PID preferred. 
  • Demonstrates good organizational, interpersonal, leadership and communication skills. 
  • Attention to detail is critical to the success of this position, with skills in customer orientation. 
  • Will need to manage multiple tasks and projects. 
  • Microsoft Office/PC skills preferred.
  • Previous work experience with an analytical focus is preferred.

Licensure, Certifications, and Clearances:

UPMC is an Equal Opportunity Employer/Disability/Veteran

Total Rewards

More than just competitive pay and benefits, UPMC’s Total Rewards package cares for you in all areas of life &emdash; because we believe that you’re at your best when receiving the support you need: professional, personal, financial, and more.

Our Values

At UPMC, we’re driven by shared values that guide our work and keep us accountable to one another. Our Values of Quality & Safety, Dignity & Respect, Caring & Listening, Responsibility & Integrity, Excellence & Innovation play a vital role in creating a cohesive, positive experience for our employees, patients, health plan members, and community. Ready to join us? Apply today.

   Current UPMC employees must apply in HR Direct

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