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 12 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.

MBE BILLING AND ACCOUNTING SPECIALIST

Work Location: In the office or hybrid (in the office 3 or more days per week)

The health and safety of our employees, members, providers, and our community is our highest priority. Therefore, all new employees are expected to be fully vaccinated against COVID-19 prior to starting at UCare, subject to limited exceptions such as for a sincerely held religious belief or for medical reasons.

Position Description

This position is responsible for complex billing/accounting processes. Serve as a liaison between Customer Service and MB&E in escalated billing cases and provide subject matter expertise (SME) guidance to support day to day work of the billing team. Support leaders in identifying and resolving member and billing system issues. Research complicated billing issues and/or member concerns. Collaborate directly with members and/or UCare staff to resolve issues and respond to internal and external inquiries. Focus on invoice preparation and processing, brokers' commissions, compares, discrepancies, reconciliations, and various complex reporting. Must maintain a thorough understanding of the billing processes and systems be able to support Billing Reps and Seniors as requested. Specialist will be assigned to a product team as their primary focus; however, work will not be restricted to one product depending on the department needs.

• Maintain a thorough understanding of duties and responsibilities of the Billing and Accounting Representative role and the Billing and Accounting Representative Senior role to ensure appropriate back up support as requested.

• Maintain working knowledge of our products, core operating systems and the detailed procedures to process enrollment and billing to ensure regulatory and contractual obligations are met and internal policies and procedures are followed.

• Assist with development, implementation, and managing the processes for identifying and tracking members to ensure compliance with CMS, DHS and/or MNsure regulations. Assist with maintaining the process for tracking all TRR codes and following CMS guidance.

• Research and support member services, CAG, Sales and Billing in resolving and responding to complex reconciliation issues and dual eligible issues. Research and verify member eligibility.

• Provide support to enrollment staff by answering questions and providing 1:1 training when appropriate. Coach and mentor team members.

• Broker communication with brokers, sales and Accounting, Broker Exception reports and AOR Files Group broker as well as Individual Broker commissions

• Prepare, compare, and generate invoice cycle for either IFP or Medicare product line. Manual invoices as needed. Late Cycle invoicing for Medicare.

• Compile and work reconciliation reports such as APTC/CSR, LEP/LIS, RPCs, MRRS Online and Group premium balancing. Pending report as needed

• Monitor and process additional complex reports such as Aging, Cash Transfer Journal Entries, Annual Statements (SSA and EFT Medicare), HRA Monthly Files. Daily cash balancing

• Participate in process and quality improvement, department initiatives/plan and employee engagement. Identify and recommend creation and/or enhancements to job aids, work instructions, Step by Steps and training.

• Identify and recommend enhancements to Billing business processes and systems. Champion system, process and product changes as part of the Billing team of MB&E.

• Meet or exceed department quality assurance expectations.

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

• Other projects and duties as assigned.

Education

Four-year degree in Accounting, Business or related field; demonstrated experience may be considered in lieu of degree.

Required Experience

Three years' experience in a healthcare setting or a health insurance plan.

Advanced experience with Excel spreadsheets and mail merge. Experience in researching and resolving complicated issues. Customer/Member engagement.

Preferred Experience

Experience with Advantasure and/or HealthRules software. Familiarity with CMS and MNSure.

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.

JOB POST DATE: 08/25/2021