Insurance Compliance Analyst

3 days ago


Newark, New Jersey, United States Axelon Full time

About Axelon
Axelon is a cutting-edge healthcare solutions provider dedicated to delivering exceptional results to our clients. We are seeking a highly skilled Insurance Compliance Analyst to join our team and contribute to our mission of excellence in healthcare services.

Job Overview
This role involves analyzing and reconciling Medicare Advantage membership enrollment records with CMS enrollment records to ensure accuracy and compliance with regulatory guidelines.

Key Responsibilities:
• Analyze and reconcile Medicare enrollment records with CMS records on a daily, weekly, and monthly basis
• Identify and resolve discrepancies in a timely manner, working closely with the team to ensure compliance with regulatory guidelines
• Develop and implement effective strategies to improve processing performance and reduce errors
• Communicate with internal and external stakeholders, including Medicare Beneficiaries, Federal Regulators, and Executives, to respond to inquiries and resolve issues
• Collaborate with the team to prepare case documents for retroactive enrollment updates and other related tasks
• Perform other duties as assigned by management

Requirements
To succeed in this role, you will need a strong background in health insurance or a related field, with at least 5 years of experience in Medicare-related roles. You must have excellent analytical skills, attention to detail, and the ability to work independently with minimal supervision. Proficiency in Access database and analytical techniques is also required.



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