The document discusses the healthcare administration industry. Key responsibilities include maintaining member profiles, processing enrollment applications and verifying eligibility. Prompt service and efficient processing are important for developing the industry. As administrators, organizations should process healthcare enrollment and claims without financial risk or compromising data accuracy. Third party administrators play a prominent role in administering or outsourcing certain responsibilities like claims processing and premium collection. The industry depends on healthcare professionals providing services to benefit patients.

1. IndustryUnderstanding the responsibilities of what the administration and management of the healthcare industry represents Consciousness

2. Organization Skills

3. Work Ethics

4. Care for OthersThe core expertise of the Enrollment Industry lies on maintaining member profiles, processing enrollment application, verifying eligibility to access an Active Coverage.Prompt service and, processing are the key functions that help to develop the Health Care Industry.1

5. Market On your annual open enrollment time carefully research your elective provider history and turnaround claims process in order to make the right choicewhich will make a difference from the others competitors.2

6. Product or Service DescriptionAs an administrator the organization should process the health care enrollment and claims without carrying insurance risk or jeopardizing the accuracy of the data. The TPAs (third party administrators) are prominent players in the managed care industry and have the expertise and capability to administer all, or a portion of the claims process. Their services also include premium collection. While some TPAs operate as units of insurance companies, they are often independent. However, hospitals or provider organizations desiring to set up their own health plans will often outsource certain responsibilities to TPA's.3

7. CompetitionWith more corporations outsourcing to third-party administrators to handle their enrollment, claims with the market for the TPA services becoming ever more competitive, it's time to consider the role actuaries can play in helping TPAs provide quality service, deliver promised outcomes and provide sustained competitive advantage.Diversity of plan options and retention of policy holders is your key for success.4

8. Industry Analysis The health care administration industry depends on the care of health-related services by professionals for the benefit of patients. To improve the effectiveness of health care services in the state and to support consumers in health care decision making, our business responsibility should be collecting, compiling, coordinating, analyzing and disseminating health related data. These data will provide accurate and timely consumers demands in order to administer and evaluate the cost of service, quality and access to healthcare. Currently there are too many options offering a private service for quality control and delivery for managing people’s confidential information, however these competitors lack of personalize services force the consumer to search for better options.5