Premium Billing and Enrollment Coordinator
Sanford Health
Summary
The Premium Billing and Enrollment Coordinator is responsible for the timely and accurate maintenance of enrollments and the billing processes in accordance with contracts, member certificates and regulatory entities.
Job description
Summary
The Premium Billing and Enrollment Coordinator is responsible for the timely and accurate maintenance of enrollments and the billing processes in accordance with contracts, member certificates and regulatory entities.
Job Description
Responsible for the daily process of the individual and business enrollments ensuring they are entered timely and accurately and that all required documentation is received. Research and resolve billing variances to maintain system accuracy. Handle questions, issues and provide detailed information on requirements to our internal and external customers. Responsible for billing processes in accordance with contracts, member certificates and regulatory entities. Responsible for daily ad hoc discrepancy reports. Process and mail letters to our members for various reasons and other duties as assigned.
Must be detail oriented with the ability to investigate and problem solve. Relies on experiences to recognize enrollment and eligibility discrepancies. Must be able to effectively communicate, verbally and written, with internal departments and clients/members regarding enrollment processes and procedures, eligibility inquires and verification of data. Demonstrates analytical ability in processing electronic enrollment files. Assimilates large amounts of information to maintain a broad knowledge base. Exercises good judgment in determining best methods of solving problems. Maintains a positive and professional relationship with internal staff, clients, members and vendors. Maintains confidentiality.
Must have complete knowledge and skills with ability to be fully proficient in an administrative area, knowledge and understanding of different markets. Solid technical skills (Microsoft Office), strong written and verbal communication skills, strong drive for results and accountability, ability to work in a team environment, demonstrates attention to detail, strong drive for results and accountability, skilled in problem identification and resolution, exceptional judgement and decision-making abilities, maintains current billing processes and ensure accuracy of member's accounts, provides exceptional customer service to clients promptly and accurately, maintains confidentiality.
Qualifications
High school diploma, or equivalent required
2 years experience in health insurance or similar industry including enrollment and eligibility preferred.
Requirements
- High school diploma, or equivalent required
- 2 years experience in health insurance or similar industry including enrollment and eligibility preferred
- Detail oriented with the ability to investigate and problem solve
- Effective communication, verbally and written, with internal departments and clients/members
- Analytical ability in processing electronic enrollment files
- Solid technical skills (Microsoft Office)
- Strong written and verbal communication skills
- Strong drive for results and accountability
- Ability to work in a team environment
- Attention to detail
- Skilled in problem identification and resolution
- Exceptional judgement and decision-making abilities
- Maintains confidentiality
Company overview
Sanford Health is one of the largest integrated healthcare delivery systems in the United States, operating as a nonprofit organization headquartered in Sioux Falls, South Dakota. Founded in 1894, the organization has grown into a comprehensive health system with 44 medical centers, 482 clinics, and more than 200 senior living facilities across 26 states and nine countries. Sanford Health provides a full spectrum of healthcare services including acute care hospitals, specialty clinics, senior care through the Good Samaritan Society, genomic medicine, global clinics, and the Sanford Health Plan insurance program. The system employs over 48,000 healthcare professionals including 1,400 physicians and delivers care through five Centers of Excellence: Cancer, Children's, Heart, Orthopedics/Sports Medicine, and Women's Health. Annually, Sanford Health handles approximately 5.3 million outpatient visits, 84,000 admissions, and 136,000 surgeries. The organization is also actively involved in medical research and education through partnerships with academic institutions, positioning itself as a regional healthcare leader in the Midwest with expanding international presence.