THIS POSITION CAN BE LOCATED REMOTELY ACROSS THE U.S.
SUMMARY:
The Senior Billing and Enrollment Analyst is an analytical role responsible to coordinate the development and implementation of programs and strategies to improve service to our customers.
RESPONSIBILITIES/TASKS:
* Monitors all Enrollment and Billing related jobs based on scheduler
* Identifies process issues as they arise, and initiates request for technical analysis and remediation through JIRA.
* Document assign and track JIRA tickets related to Enrollment and Billing through to completion.
* Interact with the various technical teams to resolve issues and system defects.
* Develop and maintain Enrollment and Billing related reports for analysis
* Monitors enrollment and billing transactions sent to ensure accuracy and timeliness based on CMS, department, and corporate requirements.
* Identifies and reports trends and issues identified and provides issue resolution.
* Supports and participates in system testing and requirements gathering related to operational readiness updates based on system enhancements, CMS software releases, and as needed.
* Monitors and triages report and correspondence including eligibility files to downstream systems, error reports, and returned correspondence.
* Provides and implements quality and process improvement initiatives and assists in the creation and implementation of policies, procedures, and workflows.
* Supports all CMS and internal audit activities as needed.
* Fosters positive working relationships with internal and external partners with open and constructive communication.
This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.
EMPLOYMENT QUALIFICATIONS:
EDUCATION:
Bachelor's degree in a related field. Relevant combination of education and experience may be considered in lieu of degree. Continuous learning, as defined by the Company's learning philosophy, is required. Certification or progress toward certification is highly preferred and encouraged.
EXPERIENCE:
Five years experience in a claims environment or equivalent experience which provides the necessary skills, knowledge, and abilities. Experience working in a Health Care environment or managed care is preferred.
SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED:
* Knowledge of Medicare Advantage processes and Centers for Medicare & Medicaid Services (CMS) guidelines for enrollment and billing.
* Excellent verbal and written communication skills and interpersonal skills.
* Strong analytical and critical thinking skills with a high attention to detail.
* Ability to be flexible in a fast-paced environment and adaptable to change.
* Ability to work independently, as well as with all levels of staff, leadership, and external partners and vendors.
* Ability to effectively prioritize, coordinate, and lead activities.
* A strong working knowledge of Microsoft office products.
WORKING CONDITIONS:
Work is performed in an office setting with no unusual hazards. Travel is required (Approximately 20%).
The qualifications listed above are intended to represent the minimum education, experience, skills, knowledge and ability levels associated with performing the duties and responsibilities contained in this job description.
We are an Equal Opportunity Employer. Diversity is valued and we will not tolerate discrimination or harassment in any form. Candidates for the position stated above are hired on an "at will" basis. Nothing herein is intended to create a contract.