Job description
The Electronic Enrollment Specialist acts as an advisor, consultant, liaison, and problem-solver for on-line and electronic file customers and other areas of the Plan. The Electronic Enrollment Specialist must use knowledge of existing business practices, systems, procedures, policies, and their inter-relationships to ensure innovative and cost effective solutions to business and technical issues.
The Electronic Enrollment Specialist is responsible for providing support to group customers and Plan personnel prior to, during and after implementation of the on-line electronic group enrollment & maintenance system (eGEMS) at Capital Blue Cross customer locations. This includes responsibility for managing the design, documentation, and implementation of customers' requests. The Electronic Enrollment Specialist is also responsible for providing ongoing technical/business support to customers.
The Electronic Enrollment Specialist is responsible for providing support to group customers and Plan personnel prior to, during and after implementation of the on-line electronic group enrollment & maintenance system (eGEMS) at Capital Blue Cross customer locations. This includes responsibility for managing the design, documentation, and implementation of customers' requests. The Electronic Enrollment Specialist is also responsible for providing ongoing technical/business support to customers.
1) Functions as project manager for implementation of the various electronic enrollment options for both individual and multi files, including high profile accounts
- Consults with a customer during the development process to determine any special processing and system requirements to implement an automated enrollment process.
- Conducts multiple meetings with customer and CBC personnel. throughout the testing of online and electronic file implementations
- Prepares the electronic enrollment presentation materials, confirmation document, implementation schedules, and documentation necessary for implementing a new electronic enrollment customer.
- Manually review EDI files to ensure specifications and enrollment data is accurate.
- Plans, organizes, and conducts formal technical training sessions on-site for electronic enrollment components and supports Marketing Representative interface with customers for all administrative functions.
- Reviews all changes to manual and automated processes to determine if revisions to existing procedures or new procedures are required. Makes necessary revisions to existing procedures or develops new procedures as required. Notifies affected customers or areas when procedures are finalized.
- Works with IT to establish security access and User ID and communication links for electronic enrollment customers to be able to view and/or update enrollment information.
- Facilitates teamwork.
2) Acts as the primary advisor/consultant for electronic enrollment. Responds to questions and determines the urgency and importance of system change requests/problems and their effects on the accounts. Makes recommendations on the feasibility of procedure and systems changes and assists in testing. Performs cost benefit analyses to support recommendations.
3) Analyzes impact of new benefits/products and other business needs on existing manual and automated processes and proposes alternatives. Develops and designs solutions to customer business problems and requirements. Quantifies the cost and business benefits of the alternative solutions and makes recommendations. Develops user requirements to propose the most feasible, cost-effective solution to address the request.
4) Develops complete and accurate project documentation and implements training programs to assist customers and CBC personnel in adapting to system modifications.
5) Guides and assists in the training of new specialists to develop a thorough knowledge tasks and requirements.
6) Approves systems and procedure changes to increase automation or improve processing accuracy or timeliness. Approves the cost and business benefits of the alternative solutions and makes recommendations, as well as, approves recommendations for the most feasible, cost-effective solutions.
7) Approves system specifications/proposals for accuracy, feasibility, cost-effectiveness, and compliance with business procedures/requirements and system flow/file interaction.
8) Maintains a professional level of competence through continued education and exposure to methodologies and technologies.
9) Participates in Corporate and departmental projects pertaining to Electronic Enrollment
Capital Blue Cross is an independent licensee of the Blue Cross Blue Shield Association. We are an equal opportunity/affirmative action employer and do not discriminate on the basis of race, color, religion, national origin, gender, sexual orientation, gender identity, age, genetic information, physical or mental disability, veteran status, or marital status, or any other status protected by applicable law.
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