Enrollment Specialist - ADAP - Remote in Connecticut

Posted 4 Days Ago
Be an Early Applicant
Hiring Remotely in Home, PA
Remote
Entry level
Insurance
The Role
The Enrollment Specialist is responsible for processing and maintaining enrollment documentation, ensuring accuracy and compliance with service level agreements. This role involves communication with providers, data collection, quality monitoring, and assisting with payment processing while seeking process improvements.
Summary Generated by Built In

Our work matters. We help people get the medicine they need to feel better and live well.  We do not lose sight of that. It fuels our passion and drives every decision we make.

Job Posting Title

Enrollment Specialist - ADAP - Remote in Connecticut

Job Description Summary

This position is responsible for processing, data entry and file maintenance of enrollment, assessment and dis-enrollment documentation for strategic business unit (SBU) operations.

Job Description

  • This is a remote work from home position but must reside in the state of Connecticut.
  • Effectively supports Prime's SBU program operations ensuring that data is entered accurately and timely as required by contract service level agreements
  • Ability to communicate effectively in a detailed and concise manner 
  • Answers incoming calls on eligibility, program benefits, plan limitations and point of sale edits from providers and discharge planners
  • Proficient use of enrollment and claims point of sale systems for research and problem resolution.
  • Assists in data collection and reporting
  • Completes bi-weekly checkwrite production for provider payment in the accounts payable system, reporting all operational issues and assisting with system issues
  • Assists with quality monitoring and provides constructive feedback
  • Forms collaborative partnerships with teammated and other departments
  • Continually seeks to improve processes and increase efficiencies
  • Ability to work through problem resolution both independently and in cooperation with others as approporiate
  • Other special projects as required by management

Responsibilities

  • Must be a team player, flexible, organized and able to manage multiple tasks
  • Possess strong verbal and written communication skills
  • Attention to detail and ability to work efficiently to meet deadlines and timelines
  • Ability to interact with internal and external clients with confidence, assertiveness and a pleasant demeanor
  • Strong computer skills and working knowledge of Microsoft Office Suite products
  • Ability and willingness to learn other proprietary computer systems quickly and efficiently
  • Works independently and with a high degree of organization
  • Experience in health care, managed care or pharmacy management preferred
  • Experience in enrollment processing/data entry

Work Experience

Work Experience - Required:

Customer Service

Work Experience - Preferred:

Education

Education - Required:

Education - Preferred:

Bachelors

Certifications

Certifications - Required:

Certifications - Preferred:

Potential pay for this position ranges from $16.00 - $23.39 based on experience and skills.

To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page and click on the "Benefits at a glance" button for more detail.

Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information, veteran status, marital status, pregnancy or related condition (including breastfeeding), expecting or parents-to-be, or any other basis protected by law. 

We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.

Prime Therapeutics LLC is a Tobacco-Free Workplace employer.

Positions will be posted for a minimum of five consecutive workdays.

The Company
HQ: Eagan, MN
3,577 Employees
On-site Workplace
Year Founded: 1987

What We Do

Everything we do is connected to helping people get the medicine they need to feel better and live well. It’s meaningful work and we’ve been doing it for over 20 years.

In the pharmacy benefit management (PBM)industry, we’re different. We’re owned by 18 not-for-profit Blue Cross and Blue Shield health plans. This allows us to control costs and empower our employees to put members first. It’s a successful combination. We have the lowest pharmacy trend in the industry and serve 28+ million members throughout the US.

In addition to core PBM services, we work closely with our clients to implement the right benefit design, clinical and specialty programs, formulary and networks. A few key products:
• NetResults™
• Specialty Drug Management
• Best in Care™
• GuidedHealth®
• Advanced Fraud, Waste and Abuse: Member and Prescriber Investigations
• Prime Analytics™
• CareCentered Contracting™Controlled Substance Management Program

Join us!
Prime is always looking for smart, purposeful people to join our team. We’re growing fast which means there are plenty of opportunities to advance and grow in your career.

At the same time, Prime supports flexibility and offers generous PTO so you can enjoy an enviable work/life balance. We’re a privately held company -big enough to make a difference and small enough for you to have an impact.

Follow Prime on LinkedIn to learn more.

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