Role Description The Membership Enrollment Specialist I processes enrollment additions, updates, changes, reinstatements, and terminations in an accurate and timely manner for the assigned product line. The incumbent is responsible for processing of renewals and premium billing. The incumbent works closely and directly interacts with external customers such as employer groups, 834 vendors and brokers/consultants, and with internal customers such as Underwriting, Account Management, Sales, Customer Service staff, Claims staff, etc. to answer questions and resolve issues. Qualifications - High School diploma or equivalent. - Minimum two (2) years' college coursework (48 semester hours) or other equivalent certification with an emphasis in general business, health plan administration, or medical-related fields of study OR minimum of one (1) year of relevant office work experience (such as claims administration, medical office, health insurance, etc.). Requirements - Strong time management and organizational skills - Results-driven with highly developed attention to detail - Primary focus on accuracy and outcomes - Customer service - Strong interpersonal skills - Keyboarding - Dependability - High integrity - Confidentiality - Problem solving - Issue resolution - Sound judgment - Computer literacy - Microsoft Office - Oral and written communication - Teamwork Responsibilities - Accepts, investigates, and responds to incoming calls, e-mails, and other forms of communication in an accurate, timely and professional manner. - Assists with employer groups, 834 vendors, brokers/consultants, Customer Service, Claims, Account Management and/or Sales staff needs, as required. - Confirms information including but not limited to: enrollment/membership status, records, questions or concerns, and database requests. - Drives and supports high-work-volume Open Enrollment activities each year. - Generates and distributes membership-related documents such as ID cards, Certificates of Coverage, Certificates of Creditable Coverage, etc. - Maintains ongoing correspondence with internal and external customers. - Performs other duties as assigned. - Processes enrollment additions, changes, reinstatements, and cancellations in an accurate and timely manner. - Provides clerical and technical support for enrolling members, membership vendors, brokers and consultants, and employer groups. - Provides excellent customer service and guidance to both internal and external customers. - Responsible and accountable for up-to-date knowledge and achievement of divisional standards related to production, quality, and dependability. Certifications - This position is identified as level three (3). This position must ensure the security and confidentiality of records and information to prevent substantial harm, embarrassment, inconvenience, or unfairness to any individual on whom information is maintained. The integrity of information must be maintained as outlined in the company Administrative Manual. - Segregation of duties will be used to ensure that errors or irregularities are prevented or detected on a timely basis by employees in the normal course of business. This position must adhere to the segregation of duties guidelines in the Administrative Manual. Employment Type - Regular ADA Requirements - 1.1 General Office Worker, Sedentary, Campus Travel - Someone who normally works in an office setting or remotely and routinely travels for work within walking distance of location of primary work assignment.

Role Description Support the department by performing as a liaison for payer communication, assisting with patient's transitions of care, and delivery of required regulatory documents. Effective communication skills to engage collaboratively with case management staff, patients/family members, and all other healthcare professionals. - All team members are expected to be knowledgeable and compliant with Prisma Health's purpose: Inspire health. Serve with compassion. Be the difference. - Supports patient throughput by performing transition of care activities (e.g., referrals and placement for post-acute services, providing notification letters to patient/family regarding regulatory rights, maintaining consistent communication with Post-Acute Providers and Care Management staff). - Manages all payer communications, including faxes and voice mails from payors for authorizations and denials. - Communicates with payors regarding discharge dates and dispositions. - Manages the authorization fields in the EMR and work accounts timely to ensure that billing is processed efficiently. - Interacts with patients and facilitates communication between care team members. - Documents communications in the EMR with payors, delivery of forms, and interactions with patients and care team members, as appropriate. - Performs other duties as assigned. Qualifications - Education - High School diploma, GED or higher. - Experience - One (1) year of unit secretary, physician practice, health insurance or related healthcare facility experience. Requirements - Organizational skills - Time management skills - Problem solving skills - Critical thinking skills - Medical Terminology course/knowledge preferred Work Shift Day (United States of America) Location Corporate - Columbia - Taylor at Marion Facility 7001 Corporate Department 70017535 Utilization Management

Role Description This job is responsible for company billing services ensuring the financial security of accounts in the Accounts Receivable (AR) for patients to ensure receipt of appropriate cash and other financial adjudications to settle account balances. This role involves performing billing activities related to account resolution and includes communication to payors, departmental leadership, and other departments throughout the Revenue Cycle. - Effective handling of bad debt, charity care, cash collections, yield affecting adjustments, accounts receivable days, and accounts receivable over 90 days. - Resolves billing inquiries utilizing a variety of tools (i.e. computer software, reports, computerized operating systems, interdepartmental resources, newsletters, and payor websites). - Provides feedback to revise and improve billing processes. - Meets billing deadlines and productivity measures while maintaining accuracy and quality. - Supports change initiatives. - Adapts behavior to the specific patient population, including respect for privacy, method of introduction to the patient, adapting explanation of services or procedures to be performed, requesting permissions, and communication style. - Other related duties as required. Qualifications - Required – High school diploma or equivalent - Required – 6 months related experience in related hospital, clinic, medical office, business services/revenue cycle, front line registration, financial counseling, banking, hotel, retail and/or customer service - Preferred – 2 years related experience in related hospital, clinic, medical office, business services/revenue cycle, front line registration, financial counseling, banking, hotel, retail and/or customer service Requirements - Must have computer skills and dexterity required for data entry and retrieval of information. - Effective verbal and written communication skills and the ability to present information clearly and professionally. - Must be proficient with Windows-style applications, various software packages specific to role and keyboard. - Good time management skills and ability to work self-directed (with minimal supervision). - Good problem-solving skills. Benefits - This employer maintains and complies with its Compliance & Privacy Program and Standards of Conduct, including the immediate reporting of any known or suspected unethical or questionable behaviors or conduct; patient/employee safety, patient privacy, and/or other compliance-related concerns. - The employer is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or disability status. Physical and Environmental Demands - Sedentary Work - Exerting up to 10 pounds of force occasionally and/or a negligible amount of force frequently to lift, carry, push, pull, or otherwise move objects. - Normal routine involves no exposure to blood, body fluid or tissue and as part of their employment, incumbents are not called upon to perform or assist in emergency care or first aid. - The incumbent has no occupational risk for exposure to communicable diseases. - There may be occupational risk for exposure to hazardous medications or hazardous waste within the environment through receipt, transport, storage, preparation, dispensing, administration, cleaning and/or disposal of contaminated waste.

Role Description The Enrollment/Billing Representative provides straightforward administrative and/or other basic business services in Enrollment/Billing. This role provides financial related support for banking and/or billing related functions to new and/or existing accounts. - Follow standard operating procedures to review and post medical payments on basic outstanding claims in pursuit of reducing the company's accounts receivable - Research, analyze, and correct complex cash posting issues - Read and understand medical explanation of benefits (remit) - Contact medical payors regarding complex payment issues - Document chart notes accurately - Escalate unresolved complex issues as needed Qualifications - Must be able to work Monday - Friday from 9am - 6pm EST with some flexibility - High school diploma or GED required - Experience posting medical payments in healthcare/insurance industry required - Proficiency in Excel (filter, sort, search, etc.) required - Experience in healthcare, insurance, pharmacy environment preferred - Prior experience in billing, reimbursement, collections or customer service preferred - Proficiency with PC and Microsoft Office suite - Word, Teams, SharePoint - Experience with RX home or Blue Zone a plus - Analytical skillset and strong attention to detail - Excellent retention and judgment ability - Proficient written and oral communication skills - Ability to work in fast-paced, payment processing environment - Reliable, self-motivated with excellent attendance - Team player who has the ability to stay on task with little supervision - If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. Requirements - For this position, we anticipate offering an hourly rate of 17.75 - 26 USD / hourly, depending on relevant factors, including experience and geographic location. - This role is also anticipated to be eligible to participate in an annual bonus plan. Benefits - Comprehensive range of benefits, with a focus on supporting your whole health - Health-related benefits including medical, vision, dental, and well-being and behavioral health programs - 401(k) - Company paid life insurance - Tuition reimbursement - A minimum of 18 days of paid time off per year - Paid holidays - Leaves of absence