Supervisor, Enrollment and Quality Assurance - Kelsey Seybold Clinic - Pearland Business 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.
Requirements
- High School Diploma or equivalent
- 3+ years of experience with Enrollment/Eligibility or in a MA Healthcare Environment
- 3+ years of experience as a supervisor/team lead or demonstrated proficiency as an Enrollment Specialist or Subject Matter Expert
- Ability to read and interpret technical reports
- Ability to understand databases including importing and exporting of data
- Proficient with various applications to include: Excel, Access, Word, Visio and Internet Explorer
- Ability to communicate technical concepts to technical and non-technical people
- Excellent written and verbal communication skills
- Be flexible, able to work overtime as needed
- Detail oriented, and work with minimum supervision to meet strict regulatory guidelines
- Solid organizational skills
Nice To Haves
- 3+ years of experience ASO Commercial Products/Managed Care
- 1+ years of Quality Assurance experience
- 1+ years of Trizetto system software experience
- Experience with EPIC CRM
- Experience CMS MARx system
Responsibilities
- Supervises Enrollment Analysts, Billing Coordinator, Coordination of Benefits Analyst and/or Team Leads for Medicare Advantage and Commercial Plans, managing daily assignments, productivity, and CMS file processing
- Resolves enrollment and eligibility discrepancies, reviews transaction reports, and ensures accurate and timely processing per CMS guidelines, including correspondence to Medicare Advantage members
- Oversees the various team, acting as a liaison between staff and management to maintain system integrity, analyze workflows, and keep processes and training up to date
- Manages the departmental quality and supports process improvements and workflow optimization for productivity
- Assists with Enrollment projects and serves as a backup to the Manager as needed
Benefits
- comprehensive benefits package
- incentive and recognition programs
- equity stock purchase
- 401k contribution
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
