Eligibility Enrollment CSR/Processor

The Enrollment & Eligibility CSR/Processor supports eligibility and enrollment functions, including member inquiries, enrollment processing, and related administrative responsibilities. Responsibilities Processing Process enrollment & legal documents for all plans Process appeals, write summaries, pursue approvals and overturn denials. Verify provider credentials and update the database. Customer Service Handle incoming telephone calls and assist members with eligibility, enrollment, benefits, and plan-related inquiries in an efficient, prompt, and professional manner. Provide high quality customer service to all Fund members by documenting telephone, written and walk-in inquiries regarding benefits, or claim status. Respond to and resolve complex issues, including those escalated by members. Serve as primary, daily contact to clients on delivery of services. Resolve complex plan provision questions and issues addressed. Raise issues as appropriate to Team Supervisor or Department Manager. Learn and use professional excellence tools and concepts to ensure efficient and quality output/service delivery. Teamwork Work cooperatively with other team members. Actively participate in team meetings and training activities. Perform additional responsibilities and projects as periodically assigned.