Medicare Advantage Premium Billing Analyst
1 month ago
As a member of the Medicare Advantage Operations team, the Medicare Advantage Premium Billing Analyst plays a vital role in ensuring accurate and timely processing of payments, reconciliation of member accounts, and issuance of invoices.
This position requires a deep understanding of Medicare Part D programs and meticulous attention to detail to maintain the integrity of member accounts.
The ideal candidate will possess excellent communication skills and the ability to collaborate with various departments to address member issues promptly and implement ADHOC resolutions to ensure high-quality member care.
Responsibilities include:
- Understand and interpret State (CA DHS) and CMS files to ensure compliance with regulations
- Utilize knowledge of finance, accounting, bookkeeping, and medical billing procedures to perform tasks effectively
- Process payments and reconcile member accounts accurately and efficiently
- Investigate and resolve payment discrepancies promptly
- Understand and contribute to enrollment operations, Medicare membership enrollment, and reconciliation processes
Salary Range:
$ $40.44 Hourly
Note:
This posted position is 1 of 2 positions available for hire. All applicants will apply through this requisition and if selected will be hired into one of the available positions.
QualificationsWe're seeking detail-oriented, self-directed professional with:
- High School Diploma or equivalent years of experience required
- Required minimum of three or more years of experience in a Medicare health plan or Managed Care - Enrollment, Disenrollment and Reconciliation
- Robust knowledge of Medicare and CMS enrollment and billing regulatory requirements
- In depth knowledge of Medicare Part D programs and CMS contracted vendors, such as RPC
- Working knowledge of Microsoft Office Suite (Excel, Word, and PowerPoint) and data visualization tools
- Skill in prioritizing and performing a variety of duties within a system that has frequently changing assignments, priorities and deadlines
- Strong knowledge of the health care model and other managed care MSO operations
- Strong critical thinking and the ability to apply knowledge at a broad level is essential
- Reliability and compliance with scheduling standards
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