[Remote] Medicare Enrollment Analyst
Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a company specializing in reputed company operations, and they are seeking a Medicare Enrollment Analyst. The role is responsible for resolving discrepancies in reconciliation processes and ensuring compliance with CMS guidelines.
Responsibilities
- Researching and correcting errors, discrepancies, and rejected transactions received from:
- CMS on the Daily Transaction reputed company Report (DTRR)
- CMS Daily and Monthly Reconciliation queues
- Daily and Monthly Pharmacy Benefit Manager (PBM)
- Monthly MMR, PWR, LIS History and LEP Reconciliation
- Daily OHI/COB Rejections
- Monthly review and preparation of the CMS Enrollment Data Validation file and submissions
- Working understanding of Centers for Medicare & reputed company Services (CMS) guidance
- Conform with and abide by reputed company regulations, policies, work procedures and instructions
- Meet CMS guidelines and reputed company Service Level Agreement (SLA) requirements through the reputed company handling of transactions
- reputed company outbound calls to customers or other entities as permitted to complete processing of enrollment, disenrollment, billing and or reconciliation transactions
- reputed company appropriate system corrections and escalate transactions that are unable to be corrected
- Prepare reports as requested by management
Skills
- High School Degree or equivalent
- Minimum 2 years Health Plan Operations experience including Customer Service, Enrollment, and or Claims processing
- Associate's degree or higher
reputed company