Healthcare Enrollment Processor, Contract/Temp (Miramar, FL)
Miramar, FL Miramar, FL Contract Contract $17.
40 an hour $17.
40 an hour 2 days ago 2 days ago 2 days ago The Membership Accounting Analyst is responsible for the timely and accurate resolution of discrepancies identified in the Enrollment, Billing and/or Reconciliation processes.
The analyst will review documentation, work items in queues and correct errors, identify trends and document resolutions.
Exciting opportunity to Work AT Home for a fast-growing healthcare organization This will be a 7 month contract position with target start date of 8/2/2023 You will need to be within driving distance to our Miramar, FL campus to complete the background/drug screen and pick up Computer and Accessories.
ESSENTIAL DUTIES AND RESPONSIBILITIES Enrollment Processing Process queue items, inter-departmental and customer requests timely and accurately Review incomplete and pending enrollment applications and disenrollment forms for correction and submission to Centers for Medicare & Medicaid Services (CMS) Review and complete Late Enrollment Penalty (LEP) Attestations Review and complete Other Health Insurance (OHI) verification and error correction Review and create retro processing packets to be submitted to the CMS Retro Processing Contractor (RPC) Billing Processing Identify and post customer payments not automatically applied by the appropriate system Respond to billing-related correspondence Review and investigate returned checks, rejected ACH and credit card transactions Process requests for automated premium payment via credit card or ACH withdrawal Review and approve/deny customer requests for premium refunds in accordance with established policies Monthly State Pharmaceutical Assistance Programs reconciliation Reconciliation Processing Researching and correcting errors, discrepancies, and rejected transactions received from:
CMS on the Daily Transaction Reply Report (DTRR) CMS Daily and Monthly Reconciliation queues Daily and Monthly Pharmacy Benefit Manager (PBM) Monthly MMR, PWR, LIS History and LEP Reconciliation Daily OHI/COB Rejections Monthly review and preparation of the CMS Enrollment Data Validation file and submissions All Functions Working understanding of Centers for Medicare & Medicaid Services (CMS) guidance Conform with and abide by all regulations, policies, work procedures and instructions Meet CMS guidelines and client Service Level Agreement (SLA) requirements through the proper handling of transactions Perform outbound calls to customers or other entities as permitted to complete processing of enrollment, disenrollment, billing and or reconciliation transactions Make appropriate system corrections and escalate transactions that are unable to be corrected EDUCATION AND EXPERIENCE High school diploma required; Associates Degree or higher preferred Minimum 2 years Health Plan Operations experience including; Enrollment (preferred), Claims processing or Customer Service.
Working knowledge of MSOffice (Word, Excel, Outlook) Job Type:
Full-time, Temporary (7 month contract) Salary:
17.
40 per hour Job Type:
Contract Pay:
$17.
40 per hour
Benefits:
Work from home Schedule:
8 hour shift Monday to Friday Weekends as needed
Experience:
Health Plan Operation Enrollment or Claims Processing:
1 year (Required) Work Location:
Remote.
Estimated Salary: $20 to $28 per hour based on qualifications.
40 an hour $17.
40 an hour 2 days ago 2 days ago 2 days ago The Membership Accounting Analyst is responsible for the timely and accurate resolution of discrepancies identified in the Enrollment, Billing and/or Reconciliation processes.
The analyst will review documentation, work items in queues and correct errors, identify trends and document resolutions.
Exciting opportunity to Work AT Home for a fast-growing healthcare organization This will be a 7 month contract position with target start date of 8/2/2023 You will need to be within driving distance to our Miramar, FL campus to complete the background/drug screen and pick up Computer and Accessories.
ESSENTIAL DUTIES AND RESPONSIBILITIES Enrollment Processing Process queue items, inter-departmental and customer requests timely and accurately Review incomplete and pending enrollment applications and disenrollment forms for correction and submission to Centers for Medicare & Medicaid Services (CMS) Review and complete Late Enrollment Penalty (LEP) Attestations Review and complete Other Health Insurance (OHI) verification and error correction Review and create retro processing packets to be submitted to the CMS Retro Processing Contractor (RPC) Billing Processing Identify and post customer payments not automatically applied by the appropriate system Respond to billing-related correspondence Review and investigate returned checks, rejected ACH and credit card transactions Process requests for automated premium payment via credit card or ACH withdrawal Review and approve/deny customer requests for premium refunds in accordance with established policies Monthly State Pharmaceutical Assistance Programs reconciliation Reconciliation Processing Researching and correcting errors, discrepancies, and rejected transactions received from:
CMS on the Daily Transaction Reply Report (DTRR) CMS Daily and Monthly Reconciliation queues Daily and Monthly Pharmacy Benefit Manager (PBM) Monthly MMR, PWR, LIS History and LEP Reconciliation Daily OHI/COB Rejections Monthly review and preparation of the CMS Enrollment Data Validation file and submissions All Functions Working understanding of Centers for Medicare & Medicaid Services (CMS) guidance Conform with and abide by all regulations, policies, work procedures and instructions Meet CMS guidelines and client Service Level Agreement (SLA) requirements through the proper handling of transactions Perform outbound calls to customers or other entities as permitted to complete processing of enrollment, disenrollment, billing and or reconciliation transactions Make appropriate system corrections and escalate transactions that are unable to be corrected EDUCATION AND EXPERIENCE High school diploma required; Associates Degree or higher preferred Minimum 2 years Health Plan Operations experience including; Enrollment (preferred), Claims processing or Customer Service.
Working knowledge of MSOffice (Word, Excel, Outlook) Job Type:
Full-time, Temporary (7 month contract) Salary:
17.
40 per hour Job Type:
Contract Pay:
$17.
40 per hour
Benefits:
Work from home Schedule:
8 hour shift Monday to Friday Weekends as needed
Experience:
Health Plan Operation Enrollment or Claims Processing:
1 year (Required) Work Location:
Remote.
Estimated Salary: $20 to $28 per hour based on qualifications.
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