Humera - Administrative and Professional Staffing

Data Entry Specialist

7 days left

Location
Minnetonka, MN, United States
Salary
Contact For Rate
Posted
Nov 13, 2017
Closes
Nov 29, 2017
Job Type
Employee
Employment Status
Full Time
Humera is looking for a Data Entry Specialist for our client, a major healthcare provider, in Minnetonka, MN.

The Data Entry Specialist provides the hands on leadership and direction for creating a modern and seamless data entry process which includes the modernization and automation development of contract management, Broker credentialing and all aspects of building and managing the distribution hierarchy structure for active interface with commissions. The management of distribution hierarchy structure includes close collaboration and coordination with Operations, Compliance, Legal and Finance as necessary for contracting and commission setup and process. The incumbent is responsible for development, management and maintenance of the contracting, credentialing, licensing, and hierarchy aspects of Medica's distribution organization. The incumbent is responsible for oversight and monitoring of United HealthCare's performance of the credentialing and commission process and associated turn-around time which may include but is not limited to assisting in the resolution of commission issues and determining an effective action plan. The incumbent reports to and works in conjunction with the Manager of Sales Operations interacting closely with all business segments (Commercial and Government) Sales and Marketing, Finance, Legal and Commission team(s) and vendors (including but not limited to UHG).

The incumbent is responsible for the above aspects of the broker lifecycle process including initial contract set-up, ongoing management/administration, changes, investigation and resolution of issues which requires assessment, analysis and corrective action.

The incumbent may interface directly with FMA's, agencies and brokers on critical issues related to contracts, credentialing, hierarchy and commissions.
This is a one month contract opportunity.


KEY ACCOUNTABILITIES:

Contracting, Credentialing and Commissions 40%
This position is responsible for the overall administration of the Broker Lifecycle process including initial set-up, ongoing management, changes, investigation and resolution of issues.
  • Ensures brokers are credentialed and appointed according to Medica policy
  • Initiates and processes all broker, agency and FMA contracting, re-contracting and credentialing activities in compliance with the requirements of Medica and relevant state laws. Ensures that the process is completed within service agreement timeframes
  • Provides Agent of Record (AOR) assignments
  • Ensures that broker credentialing information is distributed to and processed by applicable vendors in a timely manner
  • Ensures active licenses and E&O are in compliance with Medica?s requirements and are up-to-date, appropriate and accurate for each state
  • Identifies areas for improvement in the process and system capabilities needed to support a growing distribution organization. Researches and makes recommendations to management on software and automation tools that will streamline the contracting and credentialing process
  • Provides consultation as required and applicable to brokers regarding compensation (commissions)
  • Initiates, processes and monitors non-standard commissions documentation
  • Ensures accurate commission payments for new and renewing business
  • Reviews and submits required documentation to UHG for processing, including:
  • New group information
  • Commission structure changes
  • Agent of Record (AOR) changes
  • Researches and responds to escalated issues in a timely manner and communicates resolutions appropriately

Broker LifeCycle process development, administration , oversight and audit 40%
  • Collaborates with Sales, Marketing, Operations and Finance to smoothly and quickly complete the contracting process and initiates the broker's contractual relationship with Medica and the rapid transition to active production. Develops and drives the administration steps of the Broker Life Cycle relationship with Medica
  • Ensures distribution hierarchies are accurately established and consistently maintained
  • Conducts monthly audits and analyses of UHG reports on a timely basis to ensure Medica?s expectations are m
  • Develops, implements and maintains appropriate policies and procedures
  • Helps to define future state for Broker LifeCycle needs and development requirements as related to contracts, credentialing and hierarchy
  • Assesses, develops, implements and manages a modern and seamless broker lifecycle process that will include the modernization of automated systems for contracting, credentialing and hierarchy management

Direction of distribution system processes 20%
  • Provides direction for current and future development of distribution system processes
  • Acts as a resource for other areas of the company
  • Contributes to broker communications and to the content of the broker website


MINIMUM QUALIFICATIONS/REQUIREMENTS:

Minimum education level required to qualify for the position: Bachelor's degree

    Specific types of experience or skills required:
  • Minimum of 1 years of data entry experience
  • Strong verbal and written communication skills
  • Ability to manage multiple projects, tasks and timelines
  • Proficiency in MS Access, MS Excel and MS Word
  • Advanced organizational ability, creativity and problem-solving skills
  • Working knowledge of financial accounting
  • Working knowledge of sales organization hierarchy
  • Experience and thorough understanding of today's modern technology in context with broker contracts, addendums, credentialing process and insurance company hierarchy management.
  • A high degree of skill in distributor interaction to assure the broker engagement and development lifecycle is a success
  • Self-directed and able to function with little direct supervision
  • Ability to handle difficult and highly sensitive communications
  • Fully knowledgeable in all aspects of all business line administrative policies, processes and compliance requirements is required as well as a thorough understanding of the commission process and where breakdowns may create commission issues and/or payment errors
  • Adept at investigation, research and problem-solving related to hierarchy set-up and maintenance
  • Fully knowledgeable in all aspects of policy and process to identify and correct breakdowns or errors in contracting, credentialing, hierarchy
  • Ability to respond to the immediate needs of Medica distribution partners, Sales, other business units and Medica overall
  • Experience with current technology deployed for managing distribution, hierarchy systems and broker contacting
  • Knowledge and experience in contract development, writing and administration
  • Knowledge and experience in credentialing (license, E&O, etc.)

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