Customer Service Representative I - Enrollment, Geisinger Health Plan

Location: Work from home (Pennsylvania) Shift: Days (United States of America) Scheduled Weekly Hours: 40 Worker Type: Regular Exemption Status: No Job Summary: Assists in resolving customer concerns, providing appropriate education/instruction and maintaining customer satisfaction by providing the highest level of customer service. Actively participates in cross training, improving processes within the Customer Service team. Job Duties: Resolves and reconciles enrollment reports and all related eligibility issues by following policy and procedure as well as any state legislated coverage and eligibility guidelines. Initiates communication and literature to the newly enrolled Health Plan member, dependents and employer groups. Interprets and appropriately applies rules and regulations in contractual agreements and with employer groups and vendors. Performs membership data extract reports and supplies them to employer groups as an audit tool for accuracy and compliance with performance risk guarantee commitments. Updates, approves and interprets membership data and workflow produced by online software capabilities in employer group modules. Determines the eligibility of most members…