Medicare Advantage Sr. Enrollment Representative
UCLA Health Systems
Posted Thursday, April 18, 2024
Posting ID: 14970_crt:1713480627624
Los Angeles, CA
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Description
As a member of the Medicare Advantage Operations team, the Senior Medicare Advantage Enrollment Representative plays a pivotal role in processing all enrollment, disenrollment, and cancellation requests. This position requires a deep understanding of Medicare Part D programs and meticulous attention to detail to ensure accurate and timely processing. The ideal candidate will possess excellent communication skills and the ability to collaborate with various departments to address member issues promptly and implement ADHOC resolutions to sustain quality member care. Responsibilities include: * Ensure accurate completion of enrollments in accordance with CMS and other Managed Care Guidelines * Process all Enrollment, Disenrollment, cancellation requests, reinstatements and managed retro reconciliation files or requests * Reconcile daily Transaction Reply Report (TRR) and retro reconciliation files * Maintain oversight on the accuracy and timeliness of acknowledgment notices sent to members * Maintain open lines of communication with various departments to resolve member issues promptly and implement ADHOC resolutions to sustain quality member care * Understand all aspects of enrollment operations, Medicare membership enrollment, reconciliation, and benefits coordination operations * Hands-on experience with 834 EDI, State (CA DHS), and CMS files Salary Range: $28.23 - $40.44 Hourly Note: This posted position is 1 of 3 positions available for hire. All applicants will apply through this requisition and if selected will be hired into one of the available positions.
Job Qualifications
Qualifications
We're seeking detail-oriented, self-directed professional with: * High School Diploma or equivalent work experience required * Required a minimum of three years' experience in a Medicare health plan or Managed Care - Enrollment, Disenrollment and Reconciliation * Robust knowledge of Medicare and CMS enrollment and billing regulatory requirements * Initiative, problem identification, resolution and analytical skills are essential * Excellent oral and written communication skills are required * Ability to modify and adapt operational procedures to changing operational needs * Ability to develop, implement, and evaluate methods and systems to improve efficiency * Proven skills to lead and facilitate cross-functional workgroups and other meetings * Ability to work as part of a team, collaborating with colleagues * Ability to analyze and organize complex federal and private insurance regulations * Ability to travel/attend off-site meetings and conferences
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As a member of the Medicare Advantage Operations team, the Senior Medicare Advantage Enrollment Representative plays a pivotal role in processing all enrollment, disenrollment, and cancellation requests. This position requires a deep understanding of Medicare Part D programs and meticulous attention to detail to ensure accurate and timely processing. The ideal candidate will possess excellent communication skills and the ability to collaborate with various departments to address member issues promptly and implement ADHOC resolutions to sustain quality member care. Responsibilities include: * Ensure accurate completion of enrollments in accordance with CMS and other Managed Care Guidelines * Process all Enrollment, Disenrollment, cancellation requests, reinstatements and managed retro reconciliation files or requests * Reconcile daily Transaction Reply Report (TRR) and retro reconciliation files * Maintain oversight on the accuracy and timeliness of acknowledgment notices sent to members * Maintain open lines of communication with various departments to resolve member issues promptly and implement ADHOC resolutions to sustain quality member care * Understand all aspects of enrollment operations, Medicare membership enrollment, reconciliation, and benefits coordination operations * Hands-on experience with 834 EDI, State (CA DHS), and CMS files Salary Range: $28.23 - $40.44 Hourly Note: This posted position is 1 of 3 positions available for hire. All applicants will apply through this requisition and if selected will be hired into one of the available positions.
Job Qualifications
Qualifications
We're seeking detail-oriented, self-directed professional with: * High School Diploma or equivalent work experience required * Required a minimum of three years' experience in a Medicare health plan or Managed Care - Enrollment, Disenrollment and Reconciliation * Robust knowledge of Medicare and CMS enrollment and billing regulatory requirements * Initiative, problem identification, resolution and analytical skills are essential * Excellent oral and written communication skills are required * Ability to modify and adapt operational procedures to changing operational needs * Ability to develop, implement, and evaluate methods and systems to improve efficiency * Proven skills to lead and facilitate cross-functional workgroups and other meetings * Ability to work as part of a team, collaborating with colleagues * Ability to analyze and organize complex federal and private insurance regulations * Ability to travel/attend off-site meetings and conferences
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Contact Information
Email: at-jobfeeds+uclahealthsystems@careercircle.com
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
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