Supervisor, Medicare Advantage Enrollment & Billing

Blue Cross and Blue Shield of Louisiana•Monroe, LA

1d•Onsite

About The Position

The Supervisor in the Enrollment and Billing department is responsible for the end to end process for their assigned team including organizing workflow, ensuring that employees understand their duties or delegated tasks, monitoring employee productivity and providing constructive feedback and coaching. The ideal candidate will be able to manage, guide and train employees. The Supervisor will be well-versed in processes under the role’s responsibility and will be result-driven and focused, with the goal to ensure that operations are carried out productivity to ensure profitability and sustainable growth. Oversees compliance mandates coming from federal and state regulatory agencies. Manages People This role directly manages these jobs: Medicare Enrollment Specialist, Medicare Enrollment Specialist II, Senior Medicare Enrollment Specialist This role reports to departmental leadership Necessary Contacts: In order to effectively fulfill this position, the incumbent must be in contact with: Various internal departments including but not limited to: Account Managers/Executives, Accounting, Actuarial, BET, Claims Units, Claims Systems Development Specialists, Corporate Compliance, Customer Services, Executive Management, Installation Managers, IT, Legal, Marketing (including Regional Directors), Plan Performance, Provider and Benefits Specialists, Provider Contracts, Provider Reimbursement System Audit Specialists, Quality Management, Underwriting, and other Enrollment and Billing units and other departments within BCBSLA as needed. Various external departments including but not limited to: Agents, Area Offices, Broker, Department of Insurance, Department of Health and Human Resources, Department of Health and Hospitals, Group Leaders, Other plans, outside consultant, vendors and subscribers as needed.

Requirements

High School Diploma or equivalent is required.
3 years of operational experience is required.
1 year of demonstrated leadership is required.
Experience can run concurrently.
Must demonstrate verbal and communication skills with the ability to interpret and communicate information with tact, diplomacy, patience and professionalism.
Must have strong organizational and analytical abilities and effective interpersonal skills.
Must be able to recognize inconsistencies and gaps in business processes and take appropriate actions.
Must be able to prioritize multiple responsibilities, make decisions, find solutions and work independently in order to meet aggressive deadlines, and adapt to a fast-paced, changing environment.
Must be able to coach and develop front line staff.
Able to cohesively work in team environment to ensure efficient and effective completion of all tasks for assigned groups.
Must have working knowledge of relevant software (e.g., MS Word, Excel, Outlook, etc.) and related software as well as other corporate programs and applications and the ability to learn new systems.
Must have thorough insurance knowledge to apply company policies and procedures, company guidelines, state and federal laws and mandates to ensure information is current and accurate.
Residency in or relocation to Louisiana is preferred for all positions.

Nice To Haves

Bachelor's is preferred.
Enrollment & Billing experience is preferred.
A Supervisor, Enrollment & Billing who works on the Medicare LOB must have knowledge of CMS regulations, Medicare enrollment requirements, and reporting processes, as well as experience using enrollment, billing, and reporting systems such as Facets/EAM, ESI, and other Medicare-related platforms.
The applicant selected must complete the recommend BCBSLA Leadership Development Program within 6 months of start date in the supervisor position.

Responsibilities

Organizing workflow for their assigned team.
Ensuring employees understand their duties or delegated tasks.
Monitoring employee productivity and providing constructive feedback and coaching.
Managing, guiding, and training employees.
Ensuring operations are carried out productively to ensure profitability and sustainable growth.
Overseeing compliance mandates from federal and state regulatory agencies.
Administering all HR functions, including hiring, terminating, conducting performance reviews, setting performance standards, approving work schedules, assigning and directing workload, training and developing staff, and coaching.
Following CMS (Centers for Medicare & Medicaid Services) standards, including overseeing enrollment and eligibility processes, ensuring data accuracy and compliance, resolving enrollment discrepancies, and supporting system and operational improvements.
Serving as the subject matter expert of the end-to-end process.
Maintaining thorough knowledge of required lines of business, changes to recent state and federal laws and regulations, mandates, HIPPA, and company policies and procedures to lead and provide on-the-job training to the unit.
Logging daily inventories into the inventory tracking dashboard to monitor daily inventory and ensure management has knowledge about inventory levels.
Identifying system and process functionality gaps that hinder daily performance.
Responding to and notifying applicable personnel of system problems or equipment failures.
Testing and approving programming changes to ensure accurate and timely handling of issues.
Providing dedicated customer service to the assigned area.
Establishing and maintaining strong working relationships with key departments.
Facilitating enrollment and billing training as needed or requested.
Monitoring, tracking, and assigning team tasks daily.
Participating in corporate and other projects as assigned by management.
Attending or facilitating meetings as needed.
Monitoring outsourcing relationships with vendors if necessary, to ensure quality standards and service level agreements are being met.
Performing other job-related duties as assigned, within your scope of responsibilities.