- Title: Medicare Analyst
- Code: RCI-7784-1
- Location: Newark New Jersey (NJ) 07105
- Posted Date: 07/31/2020
- Duration: 4.5 Months
- Name:Steve Macwan
- Email: firstname.lastname@example.org
- Phone: 908-704-8843 ✖
Would prefer candidates with Prior Medicare experience processing enrollments
This position is responsible for the ability to understand and abide by Federal Centers for Medicare and Medicaid Services guidance. Fast-paced environment with frequent priority changes. Organization and follow-up abilities will be critical. Policy and reconciles daily systemic eligibility discrepancies.
• Reconciliation of all daily, weekly and monthly Medicare reports generated from CMS as well as researching where required.
• Deadline sensitive information processing, including Quality Audit.
• Review and analysis of reporting to dictate daily/weekly priorities.
• Working within comprehensive understanding of several databases.
• Directly respond or support a response that is rapid and professional to internal and external customers, not limited to Medicare Beneficiaries, Federal Regulators, Executives and Congress persons.
• Generating and ensuring compliance and accuracy of various types of member correspondence.
• Reconciling eligibility discrepancies relying on your ability to arrive at a consistently compliant disposition after the analysis of information from several reference-guidance, Call Center notes, multiple databases, and telephone outreach.
• Inventory control responsibility.
• Identification and communication of processing performance opportunities.
• Performs other duties as assigned by management.
• Responsible for successful administration of the delinquency outreach program for assigned members who are not current in their premium payment
• Responsible for review, reconciliation to member premium bills and financial accounts.
• High School diploma or GED required, Bachelor's degree from an accredited college or university preferred.
• Requires a minimum of three (3) years’ experience in Health Insurance, or a related Medicare experience.
• Requires detailed knowledge of system development life cycle and implementation methodologies.
• Requires excellent proficiency in structured query languages, analysis techniques and Access database.
• Has played a key role in major company initiatives and demonstrated some leadership experience.
• Has proven knowledge and experience with to translate CMS regulatory guidance.
• Requires the ability to communicate in a clear and concise manner.
• Require strong PC skills including spreadsheets and word documents.
• Requires working knowledge of programming, development, and technical architecture.