Member Enrollment Rep II

As a not-for-profit organization, Mass General Brigham is committed to supporting patient care, research, teaching, and service to the community by leading innovation across our system. Founded by Brigham and Women’s Hospital and Massachusetts General Hospital, Mass General Brigham supports a complete continuum of care including community and specialty hospitals, a managed care organization, a physician network, community health centers, home care and other health-related entities. Several of our hospitals are teaching affiliates of Harvard Medical School, and our system is a national leader in biomedical research.

We’re focused on a people-first culture for our system’s patients and our professional family. That’s why we provide our employees with more ways to achieve their potential. Mass General Brigham is committed to aligning our employees’ personal aspirations with projects that match their capabilities and creating a culture that empowers our managers to become trusted mentors. We support each member of our team to own their personal development—and we recognize success at every step.

Our employees use the Mass General Brigham values to govern decisions, actions, and behaviors. These values guide how we get our work done: Patients, Affordability, Accountability & Service Commitment, Decisiveness, Innovation & Thoughtful Risk; and how we treat each other: Diversity & Inclusion, Integrity & Respect, Learning, Continuous Improvement & Personal Growth, Teamwork & Collaboration.

As part of the Member Enrollment Team, you will be responsible for the enrollment tasks primarily for the commercial line of business, which includes the entry of information into MGBHP’s enrollment system and working with reports to resolve discrepancy issues. As business need requires, you will provide back up support for other lines of business, such as Medicaid and Medicare.

As an enrollment representative you will have many interactions with internal clients as well as group administrators, therefore excellent customer service skills are essential. Other duties include, assisting with monthly reconciliation, assisting on special projects as needed, and researching discrepancy reports. In addition, you will also provide assistance with photocopying, faxing, filing, and other general administrative duties and special projects as assigned.

• Dealing with complex enrollment issues from either internal representatives or sale staff. These issues could vary from pharmacy, eligibility, billing and group set up.
• Provide back up support for daily operations in the supervisors absence.
• Responsible for navigating various systems (QNXT, Revs, GIC Magic, etc) in order to resolve member issues.
• Responsible for understanding the distinction between different lines of business (Medicaid, Commercial, C-Chip, C-Choice, etc).
• Meet or exceed daily productivity goals
• Meet or exceed weekly QC goal
• Acting as back-up to specific job functions in the department such as, but not limited, to (troubleshooter reports. etc,)
• Responsible for reviewing daily ESI error reports.
• Participating in all team meetings and facilitating in the absence of Supervisor.
• Assisting less experienced staff with more complex issues.
• Train staff when needed
• Attend meetings/represent the department on projects.
• Responsible for more complex reports such as monthly COBRA report, and the weekly term letters.
• Anticipates and meets, or exceeds, internal and/or external customer expectations and requirements; establishes and maintains effective relationships with customers and gains their trust and respect.
• Hold self and others accountable to meet commitments.
• Ensure diversity, equity, and inclusion are integrated as a guiding principle.
• Persist in accomplishing objectives to consistently achieve results despite any obstacles and setbacks that arise.
• Build strong relationships and infrastructures that designate Mass General Brigham Health Plan as a people-first organization.
• Other duties as assigned with or without accommodation.

• Highschool degree required or the equivalent combination of training and experience, plus 3 years of related experience.
• Associates or Bachelors degree preferred.

Mass General Brigham is an Equal Opportunity Employer. By embracing diverse skills, perspectives, and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under the law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, perform essential job functions, and receive other benefits and privileges of employment.