Enrollment CSR HNGS - Full-time / Part-time

Position Purpose: This position acts as Enrollment's subject matter expert for eligibility, enrollment and billing customer service issues. Provides clear, concise, timely and accurate enrollment information to TRICARE beneficiaries via telephone or written correspondence. Researches and resolves complex and escalated inquiries from beneficiaries, Government personnel, other departments, and other contractors. Mentors other Enrollment Representatives and backs up Enrollment Lead. Identifies problems and develops and implements solutions.

Demonstrates regular, reliable and predictable attendance.

Handles incoming and outbound telephonic customer service inquiries from beneficiaries, field staff, and Government customers regarding the TRICARE enrollment program.

Handles urgent, escalated, high priority and high profile customer service issues to resolution.

Researches and resolves complex escalated issues involving enrollment exceptions, premiums applied, and billing discrepancies within internal, vendor and government systems.

Develops and maintains a comprehensive knowledge of all Health Net Enrollment policies and procedures as well as TRICARE plan types and Government policies.

Multitasks between various TRICARE plan types and systems throughout the day while maintaining accuracy, compliance and production standards in a fast-paced call center environment.

Processes enrollment transactions, change requests, plan changes, voluntary disenrollments, and premium/refund requests by validating beneficiary eligibility status, applying government mandated policies and procedures, and keying relevant enrollment record information into government systems.

Determines appropriate Primary Care Manager (PCM) assignment by analyzing and applying complex Memorandum of Understanding (MOU) contract rules.

Identifies and documents actions and other relevant information in various system applications.

Works closely with Supervisor or Lead for process improvement opportunities.

Mentors/trains other Enrollment Representatives.

Must meet or exceed departmental standards for quality, productivity and teamwork

Performs basic analysis on complex or escalated issues, including system testing and database development and maintenance. Assists with testing new processes/procedures and system enhancements.

Performs audits on beneficiary accounts, and prepares manual adjustments that cannot be accommodated by the normal billing system.

Other duties as assigned.

Education/Experience: High School diploma or equivalent required. Bachelor's degree preferred. One year experience as an Enrollment Representative ll or a Fee Representative l or equivalent experience. Three to four years call center experience. Three to four years in a related field or production environment. Health care experience preferred.

Government Security/Clearance/Citizenship Requirements: Requires US citizenship and current security clearance

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.