Service Delivery Expert in Healthcare Reconciliation

5 days ago


Tampa, Florida, United States Wipro Digital Operations and Platforms Full time

About Wipro Digital Operations and Platforms

We are a leading provider of digital operations and platforms, seeking an experienced Service Delivery Expert in Healthcare Reconciliation to join our team.

Salary: $120,000 - $180,000 per year

Job Description:

The Service Delivery Expert will lead a team responsible for accurate and compliant reconciliation of enrollment and membership data for the ACA Marketplace and Exchange line of business.

This role requires strong leadership, analytical, and project management skills, with expertise in healthcare enrollment reconciliation, specifically within the ACA Marketplace and Exchange line of business.

Responsibilities:

  • Lead a team responsible for reconciling 834 and 820 files, RCNO, RCNI, EAPS, HICS, and other relevant CMS files.
  • Develop detailed Business Requirements based on analytic research and Root Cause Analysis.
  • Provide leadership in developing metrics, continuous improvement efforts, and managing day-to-day operations related to financial reporting and analysis.
  • Design and establish teams and processes for enrollment and payment/subsidy reconciliations with CMS.
  • Utilize data analytics to identify process improvement opportunities and ensure accurate reporting of enrollment and payment/subsidy reconciliation.
  • Implement change and drive process improvements and operational efficiencies within the reconciliation processes.

Requirements:

  • Bachelor's degree in a relevant field; an advanced degree is preferred.
  • Extensive experience in healthcare enrollment reconciliation, specifically within the ACA Marketplace and Exchange line of business.
  • Strong understanding of CMS files including 834, 820, RCNO, RCNI, EAPS, HICS, and other relevant reconciliation files.
  • Proven leadership and project management skills, with the ability to develop teams and meet strategic objectives.
  • Proficiency in data analytics tools and techniques, including predictive analytics, data modeling, and revenue forecasting.

Benefits:

  • A competitive salary range of $120,000 - $180,000 per year.
  • A comprehensive benefits package, including health insurance, retirement savings plan, and paid time off.
  • Opportunities for professional growth and development in a dynamic and innovative environment.


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