Eligibility Cnslt
Eligibility Cnslt - Electronic
Job Description POSITION SUMMARY Under general supervision, verifies enrollment status, makes changes to member/client records, and addresses a variety of enrollment questions or concerns for the Children's Health Insurance Program (CHIP). Maintains enrollment databases and coordinates electronic transfer of eligibility data. Reconciles enrollment systems. Handles inbound customer calls. Responds, researches, and resolves eligibility and other enrollment related issues involving member specific information. Ensures regulatory and corporate compliance standards are met. Adheres to internal production and quality standards. EDUCATION The highest level of education desired for candidates in this position is a High School diploma, G.E.D. or equivalent experience. FUNCTIONAL EXPERIENCES Customer Service/Customer Service - Member Services - HMO products/1-3 Years TECHNOLOGY EXPERIENCES Database/Oracle/1-3 Years/End User Desktop Tools/Microsoft Outlook/1-3 Years/End User Desktop Tools/Microsoft Excel/1-3 Years/End User Mainframe Tools and Software/Rumba/1-3 Years/End User REQUIRED SKILLS Service/Creating a Differentiated Service Experience/ADVANCED Service/Handling Service Challenges/ADVANCED Service/Working Across Boundaries/ADVANCED DESIRED SKILLS General Business/Communicating for Impact/ADVANCED ADDITIONAL JOB INFORMATION This position may require regular communication with the Pennsylvania Insurance Department and its contractor to resolve enrollment and eligibility issues. Participate in occasional user acceptance testing when there are system releases. Please note that benefit eligibility may vary by position. Click here to review the benefits associated with this position. Aetna does not permit the use of tobacco related products or drugs in the workplace.