Experienced Senior Representative, Enrollment - Remote - Utilizing Expertise in Membership Eligibility and System Accuracy to Drive Operational Excellence

Introduction to Workwarp and Our Mission

At Workwarp, we are dedicated to revolutionizing the way organizations approach enrollment operations, leveraging cutting-edge technology and exceptional talent to deliver unparalleled results. As a leader in our field, we pride ourselves on fostering a culture of innovation, collaboration, and customer-centricity. Our team is passionate about making a meaningful impact, and we are now seeking an experienced Senior Representative, Enrollment to join our dynamic team. In this critical role, you will serve as a subject matter expert, driving membership eligibility inquiries, ensuring system accuracy, and collaborating with internal partners and external clients to resolve complex issues.

Job Summary and Key Responsibilities

As a Senior Representative, Enrollment, you will be responsible for handling all processes related to membership eligibility inquiries, ensuring membership accuracy within our system, and representing Enrollment Operations as a trusted expert. Your key responsibilities will include:

• Completing operational processes to resolve eligibility issues, including incoming and outgoing eligibility, and verifying other health insurance to establish primary and secondary payors in the system
• Reconciling eligibility information with State or Federal Agencies using varied methods, and analyzing and assisting with complex eligibility issues to provide resolution to internal partners and external clients
• Responding to, documenting, and tracking proceedings with State and/or Federal Agencies, including member complaints, within required Service Level Agreements (SLAs)
• Utilizing critical thinking skills to proactively communicate eligibility issue trends with Management, and managing high volumes of tasks to support regulatory requirements and service level agreements
• Contributing to technical system enhancements by performing user testing, and participating as a team player by assisting peers and Management to support department goals
• Training new staff on assignments and/or vendors on assignments, and serving as the Subject Matter Expert (SME) to support production and provide knowledgeable responses to internal and external inquiries

Essential Qualifications and Skills

To excel in this role, you will need:

• An Associate degree or equivalent combination of education and experience, with a preferred Bachelor's Degree or equivalent combination of education and experience
• 1-3 years of related work experience, with a preferred 3-5 years of experience, and intermediate Microsoft Excel and Microsoft Word skills
• A strong knowledge of Enrollment processing for Federal, State, and business regulatory requirements, with a strong system knowledge of QNXT and State portals, state reports, 834/SSRS, CMS, and other relevant applications
• Excellent communication, analytical, and problem-solving skills, with the ability to work in a fast-paced environment and prioritize daily, weekly, and monthly job tasks
• A basic knowledge of ANSI X12 834, and experience with quality review and submission of deliverables to Government Contract and State Medicaid Agencies

Preferred Qualifications and Skills

While not essential, the following qualifications and skills are highly desirable:

• Experience working in a remote environment, with a proven ability to work independently and as part of a team
• Advanced knowledge of Microsoft Excel and Microsoft Word, with experience using other software applications and systems
• A strong understanding of regulatory requirements and service level agreements, with experience working in a customer-centric environment
• Excellent time management and organizational skills, with the ability to prioritize tasks and manage multiple projects simultaneously

Career Growth Opportunities and Learning Benefits

At Workwarp, we are committed to the growth and development of our employees. As a Senior Representative, Enrollment, you will have access to:

• Comprehensive training and onboarding programs to ensure your success in the role
• Ongoing professional development opportunities, including workshops, webinars, and conferences
• Mentorship and coaching from experienced leaders and subject matter experts
• Opportunities for career advancement and growth within the company

Work Environment and Company Culture

Our company culture is built on the values of innovation, collaboration, and customer-centricity. We believe in fostering a positive and inclusive work environment, where employees feel valued, supported, and empowered to succeed. As a remote worker, you will be part of a dynamic and distributed team, with opportunities to connect with colleagues and leaders through regular virtual meetings and events.

Compensation, Perks, and Benefits

We offer a competitive salary and benefits package, including:

• A comprehensive health and wellness program, with medical, dental, and vision coverage
• A 401(k) retirement savings plan, with company match
• Generous paid time off and holiday policies
• Opportunities for professional development and growth
• A dynamic and supportive work environment, with a culture of innovation and collaboration

Conclusion and Call to Action

If you are a motivated and experienced enrollment professional, with a passion for driving operational excellence and delivering exceptional results, we encourage you to apply for this exciting opportunity. As a Senior Representative, Enrollment, you will play a critical role in our team, leveraging your expertise to drive membership eligibility inquiries, ensure system accuracy, and collaborate with internal partners and external clients to resolve complex issues. Don't miss this chance to join our dynamic team and take your career to the next level. Apply now and discover the Workwarp difference!