UCare

Membership Billing & Enrollment Representative Senior

Employer
UCare
Location
Minneapolis, Minnesota
Posted
Sep 30, 2020
Closes
Oct 24, 2020
Ref
2110
Category
Healthcare
Employment Status
Full Time
Health Care that Starts with You!

Join a truly mission-driven organization! Independent, nonprofit UCare is recognized as one of the Minnesota's leading health plans. We provide more than 225,000 members across Minnesota and western Wisconsin with the health coverage plans and services they need to maintain and improve their health. The innovative coverage we create makes a difference for Medicare-eligible individuals, individuals and families enrolled in Minnesota Health Care Programs, such as MinnesotaCare and Medical Assistance, and disabled adults with special health care needs.

UCare is growing in size, membership, products, geographic coverage, and employees. We're an organization that's going places. Be part of a team that cares about you, be part of UCare.

Rewards

Enter a highly collaborative environment where people are truly engaged, and feedback is valued. You'll enjoy a competitive salary and benefits, as well as a host of other perks, including a nationally recognized wellness program, and a bright, open, award-winning office space in Northeast Minneapolis just minutes from major freeways and retail centers.

At UCare, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.

www.ucare.org/careers/

EOE/AA

ABOUT UCARE

UCare offers Medicare, Medicaid, Individual and Family health plans - powered by the hardest working people in the industry. Our people powered teams de-complicate, advocate and always go the extra mile to help our members. We serve with integrity, compassion and commitment to do right by members, providers and government partners. Above all, we come to work excited to provide members a path for the best health of their lives.

WORKING AT UCARE

Working at UCare is more than a career; it's a mission. A mission that defines us as professionals, unites us as an organization and shapes how we interact with our members and each other. Employees join UCare and stay because of the opportunity to have a purpose-driven job.

Our strong culture has established UCare as a Star Tribune Top 150 Workplace for 11 consecutive years since the awards program began. It's a culture that embraces innovative ideas, strategic partnerships, and exemplary customer and provider experiences. Working at UCare is being a part of a people powered team dedicated to making a real difference in the lives of our members and communities.

MEMBERSHIP BILLING & ENROLLMENT REPRENSENTATIVE SENIOR

Position Description

This position is responsible for billing and enrollment processes. The goal is to be able to meet the needs of the department through flexibility in the distribution of workload and a focus on timely, accurate deliverables. Senior staff will be assigned to a product team as their primary focus, their work will not be restricted to one product depending on the department needs.

This position consists of some data entry with an intermediate level of research and data compares. These duties include both billing and enrollment processes, such as: managing feeds, research and generation of attestations and letters, tracking responses, member outreach, making determinations, and the submission of data while ensuring compliance with regulatory and contractual requirements. Serving as a department resource and liaison to provide accurate timely responses and resolution to inquiries and complaints from members, authorized parties, and internal departments is an important function of this role. Assistance with department processing will be required as the department needs to meet deadlines and targets.

• Maintain knowledge of billing and enrollment requirements (all federal, state and contractual), processes and systems and ensure requirements and timelines are followed.

• Load and process applications and enrollment reports and files including; Verify data and ensure timely submission of membership information, ensure queues are empty at end of day and 21-day process is worked daily, reconcile payments addressing issues as identified and provide eligibility updates for Pharmacy.

• Support the Late Enrollment Penalty (LEP) and Out of Area (OOA) processes including; Research issues, create letters, making determinations, data submission, monitoring the process, participating in Quality Assurance reviews and providing monthly status reports to the manager, respond to telephonic inquiries and written requests from the CMS reconsideration vendor regarding a beneficiary request for appeal of LEP. Review LEP and OOA guidance, update letters or forms through the material review process to ensure continued compliance, track status and approval and member outreach when needed.

• Support billing and invoicing processes; including, validate the cash posting balances with the daily bank deposit log. Ensure member payments received have been properly applied to members invoice and that payments balance with the bank deposit, complete the error reports pertaining to EFT account information, ensure that the data received is accurate and active, validate the cash posting balances with the daily bank deposit log, when responses are received from the vendor, submit the appropriate change to CMS, track for return on TRR and send appropriate correspondence to member, analyze the monthly aging reports to identify members that have delinquent premium. Create and mail required member correspondence. Validate correct proposed termination notice is mailed to the correct members as well as termination submitted to CMS at the proper time each month and support cash application clean up across all lines of business.

• Manage Service Forms and member correspondence. Report trends/issues and assist in developing solutions.

• Research system issues, working to address discrepancies as identified and manage standard reports.

• Participate in process and quality improvement, department initiatives/plan and employee engagement. Provide input into department policies and procedures, including creating and maintaining Step by Steps work instructions.

• Ensure department meets expectations by participating in Quality Assurance reviews.

• Assist in departmental reporting and communication to other UCare departments.

• Other projects and duties as assigned.

Education

Two-year degree or certificate in Business preferred; demonstrated experience may be considered in lieu of degree.

Required Experience

Three years' experience in a health insurance plan. Experience with Excel spreadsheets and mail merge. Experience in researching and resolving complex issues. Phone experience.

Preferred Experience

Proficient computer skills; knowledge of Microsoft office; and MACESS type software packages.

THE UCARE DIFFERENCE

The UCare difference is our people power - employees actively working on the behalf of our members to get them access to the health care they need. We value and respect each individual's ideas and contributions, and provide the freedom to grow both personally and professionally. We are centrally located, and offer onsite education, equipment and wellness resources, and a myriad of volunteer activities. If you're looking for an inclusive environment that celebrates your people power, helps you build on your strengths and gives you the opportunity to truly make a difference, we invite you to apply.

As an Equal Opportunity/Affirmative Action Employer, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.

Similar jobs

More searches like this

Similar jobs