Eligibility/Enrollment Representative

Heartland Health & Wellness Fund is a busy, medical insurance office providing benefits to more than 39,000 Union members. The Eligibility/Enrollment Representative provides the very best customer service in its growing department. Applicants will work in a productive, fast-paced office environment providing assistance to plan participants with enrollment and determination of eligibility for health care benefits. The ideal candidate has exceptional customer service skills, is self-motivated, detail-oriented, highly organized and has a strong ability to multi-task.

Heartland Health & Wellness Fund is 39,000 members strong, comprised of plan participants, spouses and dependents in Illinois, Indiana, Ohio, Kentucky, Michigan, West Virginia and Wisconsin represented by the United Food and Commercial Workers (UFCW) union. As a regional health plan, Heartland provides quality health and wellness benefits and eligibility information to its plan participants and their families.

Primary Responsibilities:

  • Resolve customer service inquiries which include member eligibility and medical benefit information
  • Process monthly eligibility reports from employers using Excel
  • Reconcile reports
  • Prepare, process and maintain new member or group enrollments
  • Reconciles eligibility discrepancies, analyzes transactional data and submits retroactive eligibility changes.
  • Interprets employer contract language and understand the qualifications needed to obtain benefits
  • Sends correspondence to members to gather information
  • Provides customer service to internal/external customers on a daily bases (approximately 40-50 calls per day)
  • Ability to remain professional and empathetic during challenging calls
  • Ability to stay focused and productive each day although tasks may change
  • Process payments for self-pay members under programs such as COBRA and Retiree plans

Required Qualifications:

  • High School Diploma/GED
  • 1+ years of customer service experience
  • 1+ years of basic work with computer and Window PC applications
  • 1+ years experience with Microsoft Word (letter writing and using templates)
  • 1+ years of experience with Microsoft Excel (filtering, sorting, creating basic spreadsheets and using functions)
  • 1+ years of data entry
  • 1+ years working in an office setting
APPLY THROUGH INDEED