Enrollment Specialist II

Job Summary

The Enrollment Specialist II is responsible for the accurate and efficient review of new and altered specialized accounts and large organizations enrollment applications submitted to Blue Cross Blue Shield of North Dakota (BCBSND). This position focuses on timely and precise input of application data, ensures applications are complete, and determines final acceptance or denial of coverage. In addition, this role collaborates with various departments to ensure all information received is acceptable under local, state and/or federal regulations. 

Essential Functions

• Ensures all paper and electronic insurance applications are keyed into the system and processed properly.
• Reviews applications for specialized self-funding accounts and large organizations having differing/specialized underwriting rules and completes reporting documentation to comply with federal guidelines.
• Possesses the knowledge to perform underwriting exceptions for self-funded insured groups and utilizes judgment to accept or deny policies.
• Communicates with proper parties if applications are approved or need alterations.
• Applies procedural steps to any applications and ensures proper follow-up regarding new or changed policies from members.
• Analyzes policies and procedures to ensure applications and policy changes are consistent with recognized standards of professional practice and reflect the intent of standards as set forth by regulatory agencies.

Knowledge, Skills and Abilities

Attention to Detail and Accuracy

Intermediate

Communication (Verbal/Written)

Intermediate

Collaboration

Basic

Task and Goal Focus

Basic

Decision Making

Basic

Problem Solving and Resolution

Intermediate

Education Requirements

Required: High School Diploma/GED

Preferred: High School Diploma/GED

Field(s) of Study: N/A

Experience Requirements

Required: Minimum of 2 Years

Preferred: Minimum of 2 Years

Experience Details: Minimum of 2 years of enrollment processing, customer service or related experience is required.

Certification, Licensures & Registration Requirements

Title: N/A

State or Agency: N/A

Equivalent combination of education, experience or training determined to be acceptable by Human Resources may be substituted, unless regulated by contract or program standards

Other Information

Job Posting Policy 6.05

New employees with Blue Cross Blue Shield of North Dakota will be eligible to apply for positions within their assigned department after successfully completing a 90-day review. For positions outside your department, you must attain a minimum of six months of service before you can apply.

Equal Opportunity Employment

Equal Opportunity Employer of Minorities, Females, Protected Veterans and Individual with Disabilities, as well as Sexual Orientation or Gender Identity.

For questions, please email careers@bcbsnd.com

This job posting will be closed 4/5/2019 at 8:00AM CST. No further applications will be considered.