JOB DESCRIPTION

　　Job Summary

　　Responsible for preparation, processing and maintenance of new members and re-enrollment. Processes and maintains health plan's member and enrollment records, employer's monthly reports, sending membership cards and materials. Verify enrollment status, make changes to records, research and resolve enrollment system rejections. Address a variety of enrollment questions or concerns received via call tracking, claims, or e-mail. Maintain records in the enrollment database.

　　KNOWLEDGE/SKILLS/ABILITIES

　　Performs processes to resolve the following eligibility exceptions within the required State/Regulatory timeframes: enrollment file errors, ID card generation errors, PCP assignments and 834 enrollment files to vendor/third party administrators.

　　Process COB eligibility through Molina application to ensure accurate information is represented in Molina's enrollment system.

　　Assists with the support of the newborn enrollment functions, to include call center requests for verification and updates, PCP assignment activity, enrollment record error reports, enrollment/disenrollment activity and Mass Member Moves.

　　Work on claims queue to ensure timely and accurate processing of claims pended due to enrollment or COB related issues.

　　Serves as the Subject Matter Expert (SME) for application data entry to the enrollment process

　　Processes the mail returned by the member providing updates or requested information

　　Processes the mail returned by the USPS for insufficient or inaccurate address; remailing as indicated and reporting inventory as required by department policy

　　Maintains the intake process for department e-mail and distributes as appropriate

　　Works the I Serve process and makes assignments to the vendor and/or Sr. Enrollment Rep as appropriate

　　Works the CMS OEC process, pulling applications from the on-line portal and pushing them through the intake process

　　JOB QUALIFICATIONS

　　Required Education

　　Associate degree or equivalent combination of education and experience

　　Required Experience

　　1-3 years

　　Preferred Education

　　Bachelor's Degree or equivalent combination of education and experience

　　Preferred Experience

　　3-5 years

　　Pay Range: $12.32 - $24.02 an hour*

　　*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

　　To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

　　Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

　　Pay Range: $12.32 - $24.02 / HOURLY

　　*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.