Duties Note: The following is not intended to be an exhaustive list of all duties required of this position.
ADA
E1. Processes eligibility transactions on a daily basis, to maintain accurate membership data: •Reviews subscriber enrollment documents •Obtains missing information; confirms data is appropriate •Researches eligibility questions and determines outcome based on the established guidelines in various tools and Desk Levels •Updates eligibility data in the system •Notifies appropriate internal or external customers by written correspondence or verbal communication
E2. Responds to and resolves subscriber, employer group and internal inquiries: •Researches eligibility issues and determines resolution from available on-line tools, resources and guidelines • Documents resolution and actions taken
E3. Reconciles premium payments for subscribers and groups: •Works with assigned subscribers and groups to ensure billing specifications are met •Assists in identification and resolution of delinquent accounts •Corresponds with employer groups and external customers through written or verbal communication as defined within the job responsibilities; this may include on-site visits with prior management approval •Researches discrepancies, takes appropriate action and notifies client
E4. Performs all job duties efficiently, accurately and at an acceptable rate of performance
E5. Maintains confidentiality and adheres to HIPAA regulations
E6. Delivers customer service in a professional, polite and efficient manner
N7. Performs other duties of a similar nature that are necessary and not inconsistent with this position or pay grade

Education/Experience/Skills Requirements
Required Education:Required Experience:
HS/GED:1 year previous related experience

Preferred Education:Preferred Experience:
HS/GED:One(1)year related experience

Required Knowledge/Skills:
1. Must meet qualifications to perform the job including satisfactory completion of all training and testing
2. Typing Skills : 30 WPM
3. Microsoft Excel test
4. Job Content test - successful completion
5. Ability to multitask in fast paced environment
6. Well organized with ability to adapt to changing business environment; exhibits attention to details and time management skills
7. Proficiency in English language skills, including spelling, punctuation and grammar, in both written and verbal communication
8. Ability to effectively communicate with internal and external contacts in a professional manner
9. Working knowledge of personal computer and application software such as Microsoft Office
10. Ability to utilize basic office equipment including PC, scanner, telephone, copier, printer, fax, calculator
11. Computer Software typically used: Facets, Excel, Content Manager, Access
Required Licenses/Certifications:
Problem Solving
Identifies eligibility or billing issues and uses available resources to determine appropriate actions.
Managerial/Supervisory Responsibilities
Does this Position have Supervisory Responsibility? No
Number of Emps Supervised:
Titles of Employees Supervised:
Financial/Budgetary Responsibilities:
Other Job Specifications:
External Contacts: Subscribers, Employer Groups (some travel as requested)
Working Conditions/Physical Demands:
Position requires:
* Must be able to work in an office environment
* Travel to employer group locations, as required.
Position involves:
* Physical Effort: Minimum; typical of most office work. Mostly sedentary work.
* Weight: lift/carry/push/pull under 10 lbs.
* Prolonged Standing
* Walking
* Repetitive Motion
* Reaching
* Bending
* Manual Dexterity Req: Eye-hand coordination and manual dexterity sufficient to effectively utilize various office equipment (phone, computer, fax machine, printer, copier, filing cabinet, etc)
* Manual Dexterity Req: Eye-hand coordination and manual dexterity sufficient to effectively use a computer with all its components for prolonged periods of time and for the majority of required tasks
* Vision Req: Close vision (clear vision at 20 inches or less)
* Vision Req: Distance (clear vision at 20 feet or more)

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability. 

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