Supervisor, Enrollment & Billing

POSITION PURPOSE:

To supervise and ensure the accurate and timely processing of group members or individual applications and group bills as well as maintain up-to-date enrollment and premium income.

NATURE AND SCOPE:

Supervises the workflow of group and individual applications, determines eligibility, tracks accuracy of all entries in the subscriber sub-system, manages the accounts receivable sub-system, and the reconciled paid bills. Oversees the group master updates and the membership records for third party vendors. Ensures issuance of identification cards and policies. May process all direct pay contracts.

Supervises the accurate and timely reconciliation of premium payments to group and individual records to reflect current status which is used in claims processing. Ensures timely and accurate billing to maintain accurate member files and timely payments. Ensures the establishment of membership and accounts receivable records. Responsible for the subscriber sub-system in Facets.

Develops and monitors procedures for handling applications, terminations and enrollment changes. Ensures proper administration of underwriting regulations. Makes decisions on questions of eligibility, including underwriting of all new applications submitted. Approves necessary refunds for membership changes or overpayments. Supervises COBRA and HIPAA administration services. Works with the Underwriting staff on unusual enrollment situations. Administers the transfer of membership to other carriers as new lines of business are added.

Develops the work unit's procedures in accordance with corporate policy. Prepares annual objectives and assures timely completion of them. Works with the department manager in preparing the budget and ensures the work unit's adherence to the approved budget.

Monitors group and individual activities to ensure that established procedures are followed, identifies procedures that need to be updated, and makes necessary changes to operations with approval of the manager. Works with the appropriate supervisors and managers of other departments to resolve problems. Prepares and maintains records of weekly production and activity reports, monitoring workload and forecasting needs for the scheduling of overtime and staffing needs. Reports significant problems, events and workload status to the manager. Utilizes discretion in reporting operating and personnel problems as needed. Changes in organizational structure and major changes in procedures and systems are reviewed with the manager prior to implementation.

Reviews applications and interviews prospective employees and hires and terminates employment with manager's approval. Assesses performance and makes salary increase recommendations. Establishes training programs for personnel and monitors quality control of work performed. Establishes and maintains performance statistics used in evaluating department activities.
REQUIREMENTS
POSITION REQUIREMENTS:

Bachelors’ degree or three-five (3-5) years related work experience within the health insurance industry to include knowledge of enrollment and billing. Prior supervisory experience strongly preferred. High level of verbal and written communication skills.

Come work for the leading Health Insurance carrier in Idaho. To learn more about the requirements for this position, to search other employment opportunities and to apply online please visit our Web site at www.bcidaho.com/careers. We offer excellent benefits and competitive salaries, including incentive programs, 401(k), paid holidays, and much more! EEO/AA/D/V