Enrollment Specialist I

Network Health's success is driven by our mission to enhance the life, health, and wellness of the people we serve. This commitment guides our decisions, including the talented individuals we bring onto our team.

We are currently seeking an Enrollment Specialist to support enrollment, disenrollment, fulfillment, reconciliation, and related activities across all Network Health products. This role involves collaborating with internal and external stakeholders to ensure timely transaction processing while maintaining compliance with state and federal regulations.

Key responsibilities include:

• Managing enrollment and disenrollment processes efficiently.
• Ensuring compliance with all regulatory requirements.
• Communicating with group contacts, members, agents, brokerage firms, and internal sales staff through written and verbal correspondence to provide exceptional customer service.

If you're looking for an opportunity to contribute to a mission-driven organization and make a meaningful impact, we'd love to hear from you.

Essential Job Duties:

• Demonstrate commitment and behavior aligned with the philosophy, mission, values and vision of Network Health
• Appropriately apply all organizational, regulatory, and credentialing principles, procedures, requirements, regulations, and policies
• Process enrollment applications, changes and terminations for all products received.
• Responsible for handling incoming and outgoing telephone calls regarding group and member inquiries as well as inquiries from Sales, Customer Service, Agent Support, Compliance, Social Services, Care Management, Finance, and other groups as needed.
• Assist in managing an organized a compliant member filing system. Responsible for maintaining and controlling access to member electronic files and assuring that they are kept in a complete and organized manner. Complete by-member submission for electronic filing on a daily basis.
• Create and maintain accurate and complete desk procedures for all tasks. Assures that procedures, documentation and communication are such that risk of legal action is minimized.
• Drafts written correspondence or requests appropriate system form letters.
• Review on a regular basis federal regulations, state mandates, legislative changes, and legal requirements for enrollment processing. Assure that policies and procedures, documentation, and communications are such that risk of legal action is minimized.
• Other duties as assigned.
  
  

Knowledge/Skills/Abilities Required:

• Strong oral and written communication skills with the ability to listen mindfully, identify gaps and ask appropriate questions
• Ability to organize one's work and space to ensure successful completion of assigned tasks within the identified timeframe
• Ability to adapt to new circumstances, information and challenges in a fast paced environment
• Ability to work independently, as well as part of a team
• Skills required include the ability to work independently and meet deadlines.
• Must possess an upbeat service-oriented attitude and be able to communicate and coordinate well with team members and external customers.
• Ability to work well under various stressful and time sensitive situations.
• Proficiency in MS Word, Excel, Outlook
• Must have high accuracy in data entry and review documents with sharp attention to detail. Ability to handle large volumes of data.
• Strong verbal, written, interpersonal, grammar, and proofreading skills. Understanding of the customer service process.
  
  

Minimum Education Required:

• High School Diploma. Associate Degree or equivalent experience preferred.
  
  

Minimum Related Years of Experience (per minimum education) Required:

• Knowledge of and operational experience with health insurance preferred.

Candidates must reside in the state of Wisconsin for consideration. This position is eligible to work at your home office (reliable internet is required), at our office in Brookfield or Menasha, or a combination of both in our hybrid workplace model.

We are proud to be an Equal Opportunity Employer who values and maintains an environment that attracts, recruits, engages and retains a diverse workforce.