Accounts Receivable Manager
Quick Med Claims, LLC
Membership Accounting Analyst, Billing
Helpware
full-time
Posted on:
Origin: • 🇵🇭 Philippines
Visit company websiteJob Level
JuniorMid-Level
About the role
- Process queue items, inter-departmental and customer requests timely and accurately for enrollment processing.
- Review incomplete and pending enrollment applications and disenrollment forms for correction and submission to CMS.
- Review and complete Late Enrollment Penalty (LEP) Attestations and Other Health Insurance (OHI) verifications and error corrections.
- Review and create retro processing packets to be submitted to the CMS Retro Processing Contractor (RPC).
- Identify and post customer payments not automatically applied; respond to billing-related correspondence.
- Review and investigate returned checks, rejected ACH and credit card transactions; process automated premium payment requests.
- Review and approve/deny customer requests for premium refunds per policy.
- Monthly State Pharmaceutical Assistance Programs reconciliation.
- Researching and correcting errors, discrepancies, and rejected transactions in reconciliation processing.
- Monthly review and preparation of the CMS Enrollment Data Validation file and submissions.
- Perform outbound calls to customers or other entities as permitted to complete processing.
- Make appropriate system corrections and escalate transactions that are unable to be corrected.
- Prepare reports as requested by management and perform other duties as required.
- Conform with CMS guidance and meet client SLA requirements through proper handling of transactions.
Requirements
- High school diploma required; Associates Degree or higher preferred.
- Minimum 2 years Health Plan Operations experience including; Customer Service, Enrollment, and or Claims processing.
- Excellent analytical, decision-making, problem-solving, team, and time management skills.
- Excellent oral and written communication skills.
- Ensure HIPAA regulations are maintained within the immediate environment.
- Knowledge of customer service best practices and principles.
- Excellent data entry and typing skills.
- Superior listening, verbal, and written communication skills.
- Ability to handle stressful situations appropriately, while demonstrating empathy.
- Resourceful, great at solving unstructured problems with little to no supervision in a fast-paced, high stakes environment.
- Team Player: Demonstrates a strong ability to contribute to the business along with business unit team members and managers; establish collaborative relationships with peers.
- Possess strong interpersonal skills and the ability to establish, develop, and maintain business relationships.
