Blue Cross and Blue Shield of Louisiana Automated Enrollment Specialist in Baton Rouge, Louisiana
We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities. We invite you to apply for a career with Blue Cross.
Responsible for ensuring the availability of all automated enrollment options to groups and individuals, including the day to day management of 834 connectivity and electronic data interchange for marketing enrollment of the entire product portfolio for group and individual. Subject matter expert on healthcare reform product provisions and portal content management. Responsible for all aspects of marketing enrollment portals site content and vendor relationships for internal and external public-facing marketing enrollment websites.
NATURE AND SCOPE
This role does not manage people
This role reports to this job: MANAGER, ENROLLMENT OPERATIONS
Necessary Contacts: All areas of Marketing, all levels of BCBSLA personnel, Group and Individual Producers, BCBSLA Group Leaders, Sales and Marketing Regional Offices, Actuarial, Legal, Corporate Communications, eCommunications, Document Management, Audit, Project Management Office, Actuarial, EDI, Accounting, Network Development, Pharmacy, Underwriting, Membership and Billing, IT, Benefits Administration, consulting firms, business owners and vendors.
Bachelors Degree in Marketing, Business, Computer Science or related field required
Four years of related experience can be used in lieu of a Bachelor’s degree.
2 years of marketing, enrollment or payroll/benefits electronic data interchange experience to include experience in automated enrollment process required
Experience in project participation as team lead preferred
Skills and Abilities
In-depth understanding of enrollment, workflow, operating systems, and relative software as they pertain to 834 processes, product portfolio, and automated enrollment preferred. Ability to analyze enrollment needs and implement necessary changes.
Medical product knowledge required, and ancillary product knowledge is preferred.
Knowledge of automated enrollment processes and tools including Electronic Data Interchange (EDI), 834 processes and spreadsheet enrollment preferred.
Must be able to develop, analyze and manipulate database information.
Strong analytical and organizational ability required. Must have ability to recognize inconsistencies and resolve them appropriately.
Able to understand and analyze vendor agreements and contracts. Must be able to effectively interpret applicable state and federal insurance laws and regulations to include healthcare reform regulations and HIPAA.
Must be able to manage client relationships, and possess effective presentation and interpersonal skills.
Intermediate skill with power point and excel or other databases required.
Must be able to work independently, set priorities, organize workflow, take initiative, establish and document efficient procedures.
Must possess flexibility, good judgment and problem solving skills.
Must be able to travel occasionally.
Licenses and Certifications
- Valid LA Life and Health Licenses preferred
ACCOUNTABILITIES AND ESSENTIAL FUNCTIONS
Responsible for managing Benefit Focus and 834 connectivity and electronic data interchange for new and existing groups.
Responsible for all aspects contracting and enabling system access to select users. Participation in work groups.
Maintains databases to track group enrollment statuses, provides reporting to work groups, and sets priorities and deadlines for moving groups through testing validation to production.
Provides ongoing education, training and communication to group leaders, producers, account managers on processes and benefits of using automated enrollment systems.
Facilitates spreadsheet enrollment for new groups and member maintenance for existing groups through automated enrollment systems.
Responsible for acquiring data from groups, vendors, producers and/or sales office, having files tested by IT, and working with groups, vendors, producers and/or sales office to provide correct data for electronic upload to company systems.
Responsible for managing reporting of plans and benefit information for the Healthcare Reform Federally Facilitated Exchange submission to CMS for on exchange products and to Department of Insurance for off exchange products.
Subject matter expert on exchange submissions and relied upon by other areas of company for managing exchange submission to CMS. As team lead, represents marketing enrollment in annual corporate projects related to the Federally Facilitated Exchange, representing group and individual product portfolios, plans and benefits relating to marketing of products for enrollment of new members and groups.
Responsible for system enhancements of marketing enrollment portals site content for internal and external public-facing websites and tools, notifying owners of all affected sites of marketing enrollment product and rate changes made by company, performing end-to-end quality testing of site data integrity for federally facilitated exchange, company marketing enrollment portals and tools, and vendor and producer direct-marketing websites, and issuing approval to release changes to public-facing sites.
Responsible for managing relationships and meeting with internal and external marketing enrollment vendors, producers and government representatives, identifying training and communication needs to ensure seamless transition of data uploads and releases.
Ensures enrollment needs are met by determining strategy for product and rate presentment in automated enrollment tools and implementing those solutions. Understanding how health reform impacts marketing enrollment processes and tools, works to implement and improve marketing enrollment processes.
Additional Accountabilities and Essential Functions
The Physical Demands described here are representative of those that must be met by an employee to successfully perform the Accountabilities and Essential Functions of the job. Reasonable accommodations may be made to enable an individual with disabilities to perform the essential functions
Job duties are performed in a normal and clean office environment with normal noise levels.
Work is predominately done while standing or sitting.
The ability to comprehend, document, calculate, visualize, and analyze are required.
An Equal Opportunity Employer
All BCBSLA EMPLOYEES please apply through Workday Careers.
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Please be sure to monitor your email frequently for communications you may receive during the recruiting process. Due to the high volume of applications we receive, only those most qualified will be contacted. To monitor the status of your application, please visit the "My Applications" section in the Candidate Home section of your Workday account.
If you are an individual with a disability and require a reasonable accommodation to complete an application, please contact firstname.lastname@example.org for assistance.
Blue Cross and Blue Shield of Louisiana performs background and pre-employment drug screening after an offer has been extended and prior to hire for all positions. As part of this process records may be verified and information checked with agencies including but not limited to the Social Security Administration, criminal courts, federal, state, and county repositories of criminal records, Department of Motor Vehicles and credit bureaus. Pursuant with sec 1033 of the Violent Crime Control and Law Enforcement Act of 1994, individuals who have been convicted of a felony crime involving dishonesty or breach of trust are prohibited from working in the insurance industry unless they obtain written consent from their state insurance commissioner.
Additionally, Blue Cross and Blue Shield of Louisiana is a Drug Free Workplace. A pre-employment drug screen will be required and any offer is contingent upon satisfactory drug testing results.
JOB CATEGORY: Sales, Marketing & Product Management