SCOPE OF ROLE
The Membership and Enrollment Specialist I is responsible for providing level one support to Bright Health members.

ROLE RESPONSIBILITIES
The Membership and Enrollment Specialist I job description is intended to point out major responsibilities within the role, but it is not limited to these items:

1. Provides Level 1 support by answering incoming calls regarding Enrollment, Eligibility and/or Premium Billing Questions.
2. Collaborates with internal and external Bright Health Partners to resolve Level 1 Enrollment and Eligibility issues.
3. Facilitates collection of outstanding premium(s).
4. Work with State-based exchange and Federal Facilitated Marketplace (FFM) to resolve Level 1 enrollment, premium, APTC/CSR disputes, or discrepancies.
5. Participate in the discovery and resolution of root cause for recurring issues.
6. Work with Members in grace period to resolve billing issues and/or collect outstanding premium.
7. Ensure that all customer needs and problems are properly communicated and managed in a way that maintains great customer relationships.

EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE
• High School diploma or GED required.
• One to three years of customer service experience required in a call center environment.
• Must have previous knowledge and/or experience working with Individual Family Health Plans(IFP), Federally Facilitated Marketplace(FFM) and the Affordable Care Act(ACA)

PROFESSIONAL COMPETENCIES
• Strong communication skills, both verbal and written (bilingual is a plus, but not required)
• Must be detailed oriented and present critical analytical thinking skills
• Must display active listening skills
• Must present strong ability to read and comprehend material presented both orally and in writing
• Organized and be able to prioritize work to meet deadlines
• Works independently with little supervision
• Able to thrive and adapt in a fast paced, stressful environment
• Must be flexible to change and open to learning new tasks as assigned
• Must have experience using Microsoft Office, along with general computer and typing skills
• Understanding of regulatory and compliance rules surrounding enrollment and eligibility
• Must have 1-2 years of Healthcare knowledge
• Must be open to any shift available based on need
• Bilingual a plus

BEHAVIORAL AND LEADERSHIP NORMS
• Bright Values: Lives the Bright Values. Is focused on positivity and respect in all service interactions. Is focused on bravery needed to develop a variety of skills. Not afraid to ask questions. Focus on the team’s successes, and how to support that effort.

• Collaboration: Is an effective collaborator that works well with the functional team and others in the organization to align on timelines and effective delivery of a project or task. Is solution oriented. Is able to work with different personality types and teammates to overcome differences in opinion and thought to achieve common company goals.

• Delivers Results: Is results oriented. Focuses on results and the best and most efficient avenue for achieving results. Helps to create process and follows process to achieve results. Ensures thorough documentation of work and process. Works with manager on goal setting to ensure timely and high-quality work product. Is focused on managing against a predetermined set of objectives.

• Exhibits Curiosity: Focuses on learning about the business at large. Seeks to understand how they can contribute to driving the business forward and how the bigger picture works. Actively participates in his/her own career development.

• Multi-tasking: Balances multiple work projects and tasks at any given time. Alongside manager or appropriate Bright teammate, re-evaluates priorities based on changing company needs to understand what must be done today. Consistently meets deadlines.

• Service Mindset: Has an outlook that focuses on creating customer value, loyalty, and trust. Responds promptly to customer and business needs. Goes above and beyond simply providing service, to build relationships with customers and anticipate needs.

• Upward Management: While balancing multiple work projects and tasks, successfully manages expectations with appropriate project owner about capacity, challenges, and barriers to success. Is not afraid to ask for help, guidance, or feedback.

WORK ENVIRONMENT
In normal circumstances, the majority of work responsibilities are performed in an open office setting, carrying out detailed work as assigned, sitting in a workspace, and working with a computer or other office equipment. Must be required to be able to sit for approximately 70% daily. Some travel may be required