Enrollment and Reconciliation Coordinator
3 weeks ago
Leading provider of Medicare Advantage insurance plans, serving seniors and other Medicare beneficiaries across the United States.
We're dedicated to providing excellent customer service, cost-effective care, and exceptional healthcare coverage.
Salary
$65,000 - $90,000 per year, depending on experience.
The salary range reflects market standards for similar positions in the region, considering the level of expertise and qualifications required for the role.
Job Description
Responsibilities:
• Conduct thorough reviews and processes of election forms, ensuring completeness of data elements, and establish group and member enrollment records according to department standards, policies, and procedures.
• Analyze and reconcile CMS transaction reply reports against the health plan's membership files, following department standards, policies, and procedures.
• Provide top-notch customer service for member-specific issues, obtaining missing or clarifying information related to enrollment and eligibility as needed.
• Stay up-to-date on CMS regulations regarding enrollment, disenrollment, and special statuses, applying this knowledge to optimize operational efficiency.
• Collaborate effectively with internal and external stakeholders to address discrepancies and resolve issues related to payment reports and activities.
Requirements and Qualifications
• Associate's degree in a relevant field or equivalent experience required.
• Relevant experience in the managed care insurance industry essential.
• Excellent communication and organizational skills, combined with attention to detail and ability to manage multiple tasks simultaneously.
• Strong analytical and problem-solving abilities, enabling effective resolution of complex issues and discrepancies.
Benefits
• Comprehensive benefits package, including medical, dental, and vision coverage starting on day one, along with retirement savings account and generous paid time off programs.
• Opportunities for professional growth and development, including tuition reimbursement and employee recognition programs.
• Relocation assistance available (subject to specific conditions and limitations).
• Participation in diversity, equity, and inclusion colleague resource groups.
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