SCOPE OF ROLE
The Membership and Enrollment Specialist Supervisor is responsible for providing exceptional and dedicated support to the MES Team, while demonstrating amp; incorporating the Bright values into day to day operations.ROLE RESPONSIBILITIES
- Provides support for MES whom answer incoming calls regarding Enrollment, Eligibility and/or Premium Billing Questions.
- Collaborates or assists MES to collaborate with internal and external Bright Health Partners to resolve Enrollment, Eligibility, Billing, and Underwriting issues.
- Provides support to MES whom facilitates collection of outstanding premiums.
- Provides support to MES whom Work with State-based exchange or Federal Facilitated Marketplace (FFM) to resolve enrollment, premium, APTC/CSR disputes or discrepancies.
- Provides support to MES and participate as needed in the discovery and resolution of root cause for recurring issues.
- Provides support to MES that work with Members in grace period to resolve billing issues and/or collect outstanding premium.
- Provides support to MES to ensure that all customer needs and problems are properly communicated and managed in a way that maintains great customer relationships.
- Assist or support MES to review all incoming enrollment quarantine items to determine whether the enrollment may be accepted, requires additional information or should be rejected.
- Assist or support MES to request and review Special Enrollment Period supporting documentation to determine whether the enrollment is valid, to ensure that all items are properly tracked, and established turnaround times are met.
- Assist or support MES to communicate directly with members to discuss impact due to retroactive changes received from state-based exchange.
- Assist or support MES to work with state-based exchange or Federally Facilitated Marketplace (FFM) to resolve enrollment, premium, APTC/CSR disputes or discrepancies.
- Participate in the discovery and resolution of root cause for recurring issues.
- Ensure that all customer needs and problems are properly communicated and managed in a way that maintains great customer relationships.
- Use customer service best practices to ensure a positive customer experience
- Other duties and responsibilities as assigned.
- Maintains a positive attitude and collaborative culture with staff, peers and other departments
- Versed in regulatory and compliance rules surrounding enrollment and eligibility, including adherence to all state and federal guidelines, as applicable
- Supervision of all assigned staff for day to day activities and assignments
- Monitors all inbound / outbound calls for statistical reporting
- Daily Dashboard Updates for call statistics and all workload assignments
- Daily, Weekly and Monthly Reporting as assigned
- PTO Approval/Denial Maintains the appropriate staffing levels to meet the daily business needs of the department
- Maintains 24 TAT for all tasks
- Becomes adept to all Systems training and assists new hire training when requested
- Consistently identifies trends for opportunity in learning and/or updating desk level procedures
- Facilitates and Leads weekly Team meetings
- Perform one on one meetings monthly with all assigned associates to review statistical performance and/or adherence to company policies.
- Consistently monitor ongoing performance of staff, including yearly performance reviews. Ability to deliver Performance Improvement Plan Action (or similar) decisions
- Other duties and responsibilities as assigned
EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE
- High School diploma or GED required
- One to Three years of IFP and/or FFM Health Insurance Industry required
- Three to Five years of customer service experience in an inbound call center required
- Claims or 834 EDI File experience preferred but not required
- One to Two years of leadership experience required
- Call monitoring and QA mentoring experience preferred but not required
- Experience with Performance Improvement Plans or similar required
- Experience with classroom and/or individual training sessions required
- Bilingual competency is recommended but not required.
ABOUT USAt Bright Health, we brought together the brightest minds from the health care industry and consumer technology and together we created Bright Health: a new, brighter approach to healthcare, built for individuals. Our plans are easy to manage, personalized and more affordable, giving people the quality care they deserve. Through our exclusive care partnerships with leading health systems in local communities we are reshaping how people and physicians achieve better health together.We’re Making Healthcare Right. Together.
- Strong communication skills, both verbal and written
- Strong organizational and time management skills. Must be able to prioritize to meet deadlines
- Works independently with little supervision
- Able to thrive in fast paced environment, must be flexible and easily able to adapt to change
- Must uphold a positive and professional demeanor during high peak times and must be able to effectively handle stressful situations with ease
- Strong attention to detail and results and have strong presentation skills to share results within the organization with full understanding.
- Strong understanding of Regulatory and Compliance rules surrounding enrollment and eligibility, including adherence to all state and federal guidelines, as applicable.
- Consistently support Bright Health Plan in a professional and positive manner
We've won some fun awards like:Great Places to Work,Modern Healthcare,Forbes, etc. But more than anything, we're a group of people who are really dedicated to our mission in healthcare. Come join our growing team!As an Equal Opportunity Employer, we welcome and employ a diverse employee group committed to meeting the needs of Bright Health, our consumers, and the communities we serve. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.