Responsible for Medicare enrollment membership processing. Significant elements of work involve verification, data entry, and filing of applications, coordination of phone calls to new members, including educating them on plan benefits, and assistance with member reconciliation.
Verification of membership eligibility through Centers for Medicare & Medicaid Services (CMS) and that all member applications are complete and accurate within specified time lines using established procedures
Daily processing of enrollment information in Amisys
Daily processing of enrollment information such as changes of address in Amisys, Macess and Rx America systems
Responsible for generation of ID cards and new member packets
Responsible for generation of membership correspondence, and provider and specialist termination correspondence and documentation as set forth through CMS
Responsible for verification of data entered into the Amisys, Macess and RX America systems, and processing any corrections to information as determined
Make phone calls to new members to verify information and educate then on plan benefits
Assist with the scanning, vertexing, vertex viewing and filing of enrollment forms and member correspondence through Macess
Responsible for the verification and system update of special membership statuses such as institutional and Medicaid
Assist with special projects as needed
Bachelor's degree in Business and/or a minimum of 3 years related work experience required. Previous enrollment and billing reconciliation, accounts receivable experience in a healthcare/hospital setting is preferred. Word processing, spreadsheet, electronic interface and database merge skills are also required.
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