Senior Membership Enrollment & Billing REMOTE Must Live In MN - MINNEAPOLIS, Minnesota | CareerCircle
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Senior Membership Enrollment & Billing REMOTE Must Live In MN

Aston Carter

02/21/2022

Posting ID: JP-002660360

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MINNEAPOLIS, Minnesota
Full Time
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This position is responsible to ensure consistency and accuracy for billing processes. Meet the needs of the department through distribution of workload and a focus on timely, accurate deliverables. Primary focus will be on a specific product team and provide support to other product teams as appropriate. Responsible for data entry with an intermediate level of research and data compares. Data entry includes, but not limited to, managing feeds, research and generation of attestations and letters, tracking responses, member outreach, making determinations, and the submission of data while ensuring compliance with regulatory and contractual requirements. Serve as a department resource and liaison to provide accurate timely responses and resolution to inquiries and complaints from members, authorized parties, and internal departments is an important function of this role. Assist with department processing to meet deadlines and targets.

· Maintain knowledge of billing requirements (all federal, state and contractual), processes and systems and ensure requirements and timelines are followed.

· Load and process applications and enrollment reports and files including; Verify data and ensure timely submission of membership information, ensure queues are empty at end of day and 21 day process is worked daily, reconcile payments addressing issues as identified and provide eligibility updates for Pharmacy.

· Support Late Enrollment Penalty (LEP) and Out of Area (OOA) processes including; Research issues, create letters, making determinations, data submission, monitoring the process, participating in Quality Assurance reviews and providing monthly status reports to the manager, respond to telephonic inquiries and written requests from the CMS reconsideration vendor regarding a beneficiary request for appeal of LEP. Review LEP and OOA guidance, update letters or forms through the material review process to ensure continued compliance, track status and approval and member outreach when needed.

· Support billing and invoicing processes; including, validate the cash posting balances with the daily bank deposit log. Ensure member payments received have been properly applied to members invoice and that payments balance with the bank deposit, complete the error reports pertaining to EFT account information, ensure that the data received is accurate and active, validate the cash posting balances with the daily bank deposit log, when responses are received from the vendor, submit the appropriate change to CMS, track for return on TRR and send appropriate correspondence to member, analyze the monthly aging reports to identify members that have delinquent premium. Create and mail required member correspondence. Validate correct proposed termination notice is mailed to the correct members as well as termination submitted to CMS at the proper time each month and support cash application clean up across all lines of business.

· Manage Service Forms and member correspondence. Report trends/issues and assist in developing solutions.

· Research system issues, working to address discrepancies as identified and manage standard reports.

· Participate in process and quality improvement, department initiatives/plan and employee engagement. Provide input into department policies and procedures, including creating and maintaining Step by Steps work instructions.

· Ensure department meets expectations by participating in Quality Assurance reviews.

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Skills:

Billing systems, excel pivot tables, excel macros, Insurance, Medical insurance, healthcare insurance, enrollment, provider enrollment, data entry, billing, research, process applications

Top Skills Details:

Billing systems,excel pivot tables,excel macros,Insurance

Additional Skills & Qualifications:

Education

Two year degree or certificate in Business preferred; demonstrated experience may be considered in lieu of degree.

Required Experience

Education

Two-year degree or certificate in Business preferred; demonstrated experience may be considered in lieu of degree.

Required Experience

Three years’ experience in a health insurance plan. Knowledge of Microsoft Office products, intermediate skill level with Excel spreadsheets. Experience in researching and resolving complex issues. Phone experience.

Preferred Experience

Proficient computer skills; Advanced Skill level with Excel (utilization of formulas and V-look ups); and MACESS type software packages.

Experience Level:

Expert Level

About Aston Carter:

At Aston Carter, we’re dedicated to expanding career opportunities for the skilled professionals who power our business. Our success is driven by the talented, motivated people who join our team across a range of positions – from recruiting, sales and delivery to corporate roles. As part of our team, employees have the opportunity for long-term career success, where hard work is rewarded and the potential for growth is limitless.

Established in 1997, Aston Carter is a leading staffing and consulting firm, providing high-caliber talent and premium services to more than 7,000 companies across North America. Spanning four continents and more than 200 offices, we extend our clients’ capabilities by seeking solvers and delivering solutions to address today’s workforce challenges. For organizations looking for innovative solutions shaped by critical-thinking professionals, visit AstonCarter.com. Aston Carter is a company within Allegis Group, a global leader in talent solutions.

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.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please call 888-237-6835 or email astoncarteraccommodation@astoncarter.com for other accommodation options. However, if you have questions about this position, please contact the Recruiter located at the bottom of the job posting. The Recruiter is the sole point of contact for questions about this position.

Contact Information

Recruiter: Alissa Duckett

Phone: (952) 852-2222

Email: alduckett@astoncarter.com

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