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Enrollment Services - Enrollment Specialist - Commercial

CommunityCare • Tulsa, OK, US • published 2026-10-24 08:05:11.068402

Description

**JOB SUMMARY:** Responsible for processing advanced enrollment and membership transactions, such as report review, transaction reconciliation, renewal and PCP routes, new group audits, system updates, correspondence, notices, prior coverage requests, ID card and output audits, and HICS case resolution. Maintains policies, procedures, and process documentation while adhering to service level agreements, audit\-reviewed processes, and applicable regulatory guidance to support timely, accurate, and compliant enrollment operations. **KEY RESPONSIBILITIES:** * Process advanced employer group enrollment and membership transactions; prepare and audit New Group, Provider and renewal routes. * Review and process enrollment reports to identify required system updates, corrections, reconciliations, or escalations. * Reconcile enrollment transactions across systems, reports, source documentation, and membership records to ensure accurate and timely updates. * Administer renewal routes, PCP routes, and new group audits to support accurate employer group setup, renewal processing, and ongoing membership maintenance. * Create, review, and generate enrollment\-related correspondence, notices, pri...

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