[Hiring] Enrollment Specialist II @Utah Retirement Systems

Role Description

Plays a critical role in PEHP’s efforts to serve and create value for our members by making sure members are properly enrolled in PEHP products and special events for COBRA, Leave, and LTD are accurately recorded. Performs a variety of duties to handle incoming calls, faxes, and emails regarding enrollment and eligibility for all PEHP plans. Successful performance for the position requires a genuine interest in helping others, the ability to maintain accurate and timely records for members and employer groups, and a high level of commitment and dependability.

Qualifications

• High School diploma or equivalent.
• Two (2) years experience within the insurance industry performing clerical duties related to processing of enrollments, employment status, changes, and premium collections of group insurance members, or an equivalent combination of education and experience.
• Six (6) months experience with PEHP is preferred.
• Specific experience within the insurance industry enrollment and claims processing is preferred.

Requirements

• Processes member enrollment and change forms, including data entry into PEHP system, verifying proper completion of enrollment and change documentation.
• Requests and verifies information as needed to expedite enrollment.
• Audits daily online enrollment activity and periodic electronic enrollment activity.
• Follows up with employer groups, third party vendors, brokers, and members to complete enrollment and change process.
• Processes and monitors actions related to COBRA, Leave, LTD, and COBRA benefits ensuring compliance with HIPAA, COBRA, FMLA, Leave without Pay, ACA, and IRS regulations.
• Accesses imaged documents for historical verification to respond to employer groups, brokers, or members.
• Interviews and counsels walk-in members regarding eligibility in PEHP retiree health plans, employer paid health benefits, and Medicare related questions.
• Assists in completion of application forms and initiates related premium billing or deduction plans.
• Verifies that retiree enrollment information is authorized by the employer group.
• Educates current and prospective retirees on the benefits of PEHP Medicare and Medigap plans.
• Makes outbound calls to potential Medicare Supplement members to inform them of PEHP’s products.
• Provides telephone technical support for members using the PEHP online enrollment system.
• Performs comprehensive monitoring of benefit payments (eligibility, premiums, billing) to assure proper credit to employer groups and members.
• Monitors payroll deduction reports to ensure proper payroll deductions.
• Performs online updates on State payroll system (SAP) to start, adjust, or refund deductions as needed.
• Coordinates billing/refund issues within the department and with Accounting staff.
• Performs complex and technical aspects of enrollment and maintenance of special programs such as early retirements and Medicare supplement plans.
• Processes periodic EDI/flat enrollment/change files from brokers and employees.
• Researches and processes monthly reports to verify active employment terminations, transitions to Medicare, or other status changes.
• Mails letters and appropriate enrollment forms to prospective and current retirees.
• Responds to ORS dependent orders, verifying or adding dependents.
• Provides certificates of coverage, COBRA information, rates, and other documents as requested.
• Maintains enrollment process documentation for department use, reference, and training.
• Maintains accurate and accessible filing system for non-imaged reports and forms.
• Maintains regular and reliable attendance.
• Maintains strict confidentiality.
• Performs special projects and other related duties as needed.

Benefits

• Competitive salary with generous benefits.
• Personal development in a positive team environment.
• Excellent work-life balance.
• Remote work available for 9 out of every 10 workdays.