Enrollment Data Specialist

24 hours ago


Houston, Texas, United States Team1Medical Full time
Job Overview

We are seeking a highly skilled Enrollment Data Specialist to join our team at Team1Medical. As a key member of our staff, you will play a critical role in ensuring the accuracy and efficiency of our enrollment processes.

Key Responsibilities
  • Eligibility Determination: Determine member eligibility and process requests according to regulatory guidelines, ensuring compliance with all relevant regulations.
  • Transaction Analysis: Perform research and resolve errors/discrepancies related to transactional data within internal systems, ensuring data integrity and accuracy.
  • Enrollment and Billing: Submit enrollment and eligibility disputes to regulatory entities, complete internal case inquiries, and reconcile accounting and membership data to align with regulatory requirements.
  • Account Refunds: Process account refunds in a timely and accurate manner.
  • Regulatory Compliance: Stay up-to-date with the latest communications, regulatory requirements, industry best practices, and guidance provided by regulatory entities.
Requirements
  • Education: High school diploma or equivalent required.
  • Experience: Two years of experience in health insurance, managed care, or customer service.
  • Skills: Knowledge of eligibility files/premium billing, Medicare preferred; Medicaid/CHIP familiarity highly preferred; Microsoft Office experience (Word, Excel, Outlook) a plus.
Benefits
  • Work Schedule: Monday – Friday, 8:00 a.m. – 5:00 p.m., with no weekends.
  • Remote Work Option: Opportunity to work from home after training.
  • Benefits Package: Comprehensive benefits program, including medical, dental, disability, critical illness, life, vision, accident, and behavioral health insurance; 401K, direct deposit, and referral bonus program.

At Team1Medical, we value diversity and encourage applicants from all backgrounds to apply. As an equal-opportunity employer, we foster an environment of respect, integrity, and trust in every aspect of employment.


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