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Enrollment Representative Resume

Brooklyn, NY

SUMMARY:

I assisted new and existing clients with their demographic imformation to help minimize their debt balance with creditors they owed. Negotiated with creditors to reduce debt and set up a payment plan until negotiated amount is payed off to clear their credit.

PROFESSIONAL EXPERIENCE:

Confidential, Brooklyn, NY

Enrollment Representative

Responsibilities:

  • Temporary employee performing duties that provides clerical support to the enrollment department. Receives referral information and evaluates for membership.
  • Enter enrollment data in clinical information system and ensures the completeness and accuracy of the demographic information through verification of date of birth, sex, address, social security number, Medicaid number, and Medicare number.
  • Transmit and tracks enrollment materials to Human Resources Administration (HRA). Drafts official correspondence to referral sources, prospective enrollees and their families with regard to enrollment and eligibility.

Confidential, New York City, NY

Enrollment Specialist

Responsibilities:

  • Traveled to hospitals, clinics, private dr. offices, and healthcare facilities to get members of Confidential primary care physician’s signatures on care plan physician’s orders so they can continue receiving healthcare services

Confidential, Franklin Lakes, NJ

Client Benefits Analyst

Responsibilities:

  • Received, reviewed, and analyzed intake forms in order to set up and configure client Medicaid and Workers comp benefits (ex: copays, group build, accumulators, & products) on various systems. Validated and tested benefits setups.
  • Work with cross - functional teams to confirms and establish client requirements. Ensured all client deliverable were managed and set up on time and accurately.
  • Follow all established SOP’s to remain compliant.

Confidential, Park Ridge, NJ

Enrollment Specialist

Responsibilities:

  • Handled complex/escalated employee concerns, eligibility and transaction issues. Escalated issues to supervisors when appropriate.
  • Troubleshoots issues with data/eligibility files .Supported benefit team with processing status change
  • Assisted in ensuring compliance with local, state and federal legislation related to benefits.

Confidential, Little Falls, NJ

Benefits Specialist

Responsibilities:

  • Enroll Cisco Systems & Confidential & Confidential employees worldwide into their health & welfare benefits while answering employee questions about different health plans (HMO, PPO, PSO, Secondary Medicare, etc.) and flexible spending accounts
  • Resolve discrepancies as well as provide pertinent information about their 401K.
  • Ensure HIPAA compliance and Followed CMS guidelines

Confidential, Newark, NJ

Enrollment Specialist

Responsibilities:

  • Dealt with Insurance Brokers to enroll participants in to individual policies through Confidential .
  • Process consumer applications for health insurance accurately.
  • Ensure the accuracy of the Codes. Coded consumer health products for correct billing (dependent on the plans/products such as HMO - PPO etc.)
  • Prepare, verify data related to consumer information and health products and rates for HMO, EPO Basic & Plus plans to be processed in India
  • Edit and correct any errors on consumer applications to be processed immediately

Confidential, Little Falls, NJ

Benefits Representative

Responsibilities:

  • Answer high volume incoming inquiries, forward them to various departments
  • Supply pertinent information regarding university benefits and resolve discrepancies
  • Enroll Stanford University faculty, staff, and employees into health & welfare benefits
  • Worked with a variety of plans such as HMO, Medicare, PPO, PSO etc.
  • Ensure HIPAA compliance and Followed CMS guidelines

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