Enrollment Processor, Intermediate

IFP Install And CEC Team Support

The IFP Install and CEC team support our consumer line of business by managing the eligibility and reconciliation of our IFP membership for both on and off-exchange membership. The Enrollment Processor, Intermediate will report to the Operations Supervisor, IFP Install. In this role you will review and reconcile eligibility data, support our vendor team with clarifications and work with internal and external stakeholders to ensure our IFP membership has accurate eligibility and rates.

Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

In this role, you will:

• Regularly contact internal and external customers and business partners to verify or obtain additional information to complete processing work
• Verify accuracy of entered data against source documents
• Utilize multiple sources to verify and reconcile eligibility information
• Process group or member level enrollment, cancellations and changes
• Make decisions based on review of source documents for routine and difficult processing issues
• Work with internal and external stakeholders to align eligibility and address discrepancies
• Ability to communicate effectively with internal and external business partners

In this role, you will need:

• High School Diploma or GED
• At least 3 years of prior relevant experience in Health Insurance (e.g., claims, customer service, processing)
• Knowledge of Covered California Eligibility guidelines and enrollment processing preferred
• Knowledge of Facets, SAS, Edifecs, PEGA, & Cal Heers preferred
• Intermediate-Advanced skills creating documents/files using Excel, Outlook, Power Point, and Word

Hybrid Virtual Work

This role allows employees to work virtually full-time, however employees will be expected to come to the office based on business need.

Blue Shield of California became a subsidiary of Ascendiun as of January 2025. Ascendiun is a nonprofit corporate entity that is the parent to a family of organizations including Blue Shield of California and its subsidiary, Blue Shield of California Promise Health Plan;
Altais, a clinical services company; and Stellarus, a company designed to scale healthcare solutions. Together, these organizations are referred to as the Ascendiun Family of Companies.

At Blue Shield of California, our mission is to create a healthcare system worthy of our family and friends and sustainably affordable. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.

To achieve our mission, we foster an environment where all employees can thrive and contribute fully to address the needs of the various communities we serve. We are committed to creating and maintaining a supportive workplace that upholds our values and advances our goals.

Blue Shield is a U.S. News Best Company to work for, a Deloitte U.S. Best Managed Company and a Top 100 Inspiring Workplace. We were recognized by Fair
360 as a Top Regional Company, and one of the 50 most community-minded companies in the United States by Points of Light. Here at Blue Shield, we strive to make a positive change across our industry and communities – join us!

Our Values:

• Honest
• Human
• Courageous

Our Workplace Model

We believe in fostering a workplace environment that balances purposeful in-person collaboration with flexibility - providing clear expectations while respecting the diverse needs of our workforce. Our workplace model is designed around intentional in-person interaction, collaboration, connection, creativity and flexibility:

• For most teams, this means coming into the office two days per week.
• Employees living more than 50 miles from an office location, out of state employees, and employees in certain member-facing roles should work with their manager to determine in-office time based…