Member Enrollment and Billing Coordinator - Kelsey Seybold Clinic - Kelseycare Ops - Pearland Admin Office
About The Position
Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health care organizations and build your career at one of our 40+ locations throughout Houston. Be part of a team that is nationally recognized for delivering coordinated and accountable care. As a multi-specialty clinic, we offer care from more than 900 medical providers in 65 medical specialties. Take on a rewarding opportunity to help drive higher quality, higher patient satisfaction and lower total costs. Join us and discover the meaning behind Caring. Connecting. Growing together. Primary Responsibilities: Creating data extracts for starting the billing cycle, preparing and sending out account holder statements, managing payment receipts and postings, applying adjustments, handling collections, reconciling accounts monthly, and making necessary changes to member eligibility It also involves collaborating with the fulfillment vendor to ensure statements and notices are dispatched accurately and on time and working closely with the Finance Department to reconcile accounts Additionally, this position conducts quality checks on the work of Enrollment Analysts concerning premium billing and provides feedback on their performance to management The role is also tasked with conducting user acceptance testing for enrollment and premium billing systems and supports the Enrollment Reconciliation Analyst in processing data files and carrying out research and analysis on various enrollment-related tasks You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Requirements
- Bachelor's degree in related field (e.g., Finance or Healthcare). Directly related work experience will be considered in lieu of degree on 1:1 basis
- 1+ years of experience billing processing in a related field
- 1+ years of experience working in a Medicare Advantage Plan
- Knowledge of Health Insurance Operations including Ability to Interpret/Apply CMS Regulations regarding Enrollment and Premium Billing
Nice To Haves
- 3+ years of experience in medical plan enrollment
- Experience in Customer Service in Healthcare Industry
- Working knowledge of Epic Tapestry system
- Working knowledge of TriZetto Enrollment Administration Manager (EAM) application
- Proven ability to read and interpret technical reports
- Proven ability to analyze and interpret data using Microsoft Excel and Access and provide feedback to appropriate personnel
Responsibilities
- Creating data extracts for starting the billing cycle
- Preparing and sending out account holder statements
- Managing payment receipts and postings
- Applying adjustments
- Handling collections
- Reconciling accounts monthly
- Making necessary changes to member eligibility
- Collaborating with the fulfillment vendor to ensure statements and notices are dispatched accurately and on time
- Working closely with the Finance Department to reconcile accounts
- Conducting quality checks on the work of Enrollment Analysts concerning premium billing and provides feedback on their performance to management
- Conducting user acceptance testing for enrollment and premium billing systems
- Supporting the Enrollment Reconciliation Analyst in processing data files and carrying out research and analysis on various enrollment-related tasks
Benefits
- a comprehensive benefits package
- incentive and recognition programs
- equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements)
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Number of Employees
5,001-10,000 employees
