Job Details

Division Choice Administrators
Location Orange
State CA
Requisition Number 21-0039
Post Date 5/7/2021
Job Title Processing Center Administrator I
Description

Purpose of Position: The ChoiceBuilder Administrator I is responsible for providing ongoing support to the Processing Center; to include verifying eligibility, processing member and group materials for participants in the Choice Builder program, and other projects.  

 

Essential Functions:

• Understand company policies and procedures as they apply to Choice Builder plans.

 

• Follows all established processes and procedures to ensure integrity, security and confidentiality of all data.

 

• Receives, processes and verifies the accuracy of employee applications, change requests, terminations, as well as some group documents with a high level of accuracy.

 

• Communicates with clients and brokers via phone, fax or email clearly and confidently (i.e. denials, confirmation, memos, letters, etc.).  Additionally, provides concise pending item requests to obtain missing or incomplete information via phone, fax or email.

 

• Identifies and reports inconsistencies found in the data.

 

• Ability to explain (verbal and written) all eligibility requirements and procedures to internal and external customers.

 

• Ability to enter appropriate comments in a clear and concise manner into Opportunity and/or Doc-Link.

 

• Ability to assess and forward documents to the appropriate team(s) or department.

 

• Meet and maintain department standards for quality, quantity of work, and service levels; performing the tasks and functions necessary to manage daily work bin.

 

• Adhere to all PHI (Personal Health Information) guidelines.

 

• Assist with providing feedback regarding training needs based on interaction with team member(s) or department(s).

 

• On-site regular attendance and punctuality are essential functions of the job.

 

• Performs other business tasks or functions as assigned.

 

Requirements

Knowledge, Skills & Abilities Required:

• Strong communication skills (written, grammatical and verbal) required.

 

• Ability to interact and communicate effectively with all levels of employees and customers.

 

• Must have strong attention to detail, strong analytical skills and problem analysis/solving skills to identify trends and improve processes to resolve issues.

 

• Ability to perform comfortably in a fast-paced, deadline-oriented professional work environment.

 

• Excellent customer service and organizational skills.

 

• Ability to retain large quantities of information.

 

• Must be able to handle multiple tasks at one time.

 

• Accurately type a minimum of 50 WPM.

 

• Proficient with Microsoft Office software (Access, Word, Excel, PowerPoint, Visio, Publisher, SharePoint, Outlook), web based technology.

 

• Must be highly motivated, have ability to take initiative, be accountable, have excellent interpersonal, and service oriented skills.

 

• Knowledge of the healthcare industry a plus

 

Additional Competencies

• Customer Focus, Humor, Listening, Self-Knowledge, Time Management, Written Communication

 

In addition to the KSAs and Additional Competencies listed above, there are more competencies related to this position. Please refer to the Individual Contributor – Associate competency addendum.

 

Educational Requirements:

• High school diploma or equivalent required.

 

• 2+ years of office and/or customer service experience required.

 

• At least one year of data entry experience required.

 

Physical Requirements: Must be able to sit for extended periods of time and occasional standing and walking.  Must have adequate hearing for phone work.  Vision requirements include close vision and the ability to adjust focus. Must be able to communicate effectively in English.  Must be able to use a keyboard and other office equipment.  Ability to lift up to 10 pounds occasionally.

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