• Process enrollment forms/spreadsheets for new and existing groups including COBRA • Process change of address forms • Review and process enrollment changes including adding/removing dependents and effective/term date adjustments • Research and correct ID cards returned with missing addresses • Addresses vision error reports • Assist in working electronic group error reports when necessary • Quality assurance review of enrollments for other Eligibility Representatives • Maintain communication with all internal departments and employer groups • Support training of new Enrollment employees • Completes special projects as assigned by management; performs tasks necessary to ensure efficient and cost-effective operation of the eligibility department • Review and update of automated reporting as assigned • Work with groups, TPA’s and internal departments for TPA changes of EDI files, provide testing and approval for production • Provide discrepancies for large and or complex groups • Process EDI files as assigned • Act as a liaison for groups and brokers regarding enrollment-related inquiries • Address emails submitted to the Enrollment inbox as needed for back-up • Process enrollment forms/spreadsheets for new and existing electronic groups as needed • Ensure compliance with HIPAA and other regulatory requirements • Support the eligibility call center

• Grow territory significantly while maintaining relationships with customers and manufacturers. • Strong technical communication skills to explain how products work and solve problems. • Manage schedule, book of business, and customer communications effectively. • Engage with customers, including hand-delivering orders as necessary.

• Uphold and integrate the customer’s Catholic and Christian identity to foster the teachings of the Church in all aspects of job performance. • Strictly adhere to HIPAA guidelines, conducting rigorous identity verification before disclosing any protected health information. • Verify member eligibility and gather necessary information to assist with member inquiry. • Efficiently authenticate and respond to provider request regarding patient policy status, effective dates of coverage, benefits, claim status, and other inquiries. • Inform members and providers on services requiring prior authorization and track the status of pending requests. • Maintaining detailed, audit-ready logs of every call, chat, and email interaction, including clear notes on the specific resolution or next steps promised. • Assist with producer support by performing regular DOI portal audits and checking Sircon credentials to verify active licensing status. • Perform other duties as assigned.

• Review order notes • Calculate pricing • Contact suppliers websites or call • Clarify missing information with AE