HealthAxis Group
100% Remote!
Full-time Seasonal Position
Now thru the end of March 2023!
Why work at HealthAxis
Established in 1965 to deliver healthcare technology and solutions to a variety of healthcare organizations throughout the United States, HealthAxis Group equips payers, providers, and health organizations with integrated solutions from an advanced claims system and TPA services to actionable analytics. We streamline operations and improve client and patient outcomes. HealthAxis Group offers hosted, Internet-based benefits distribution and administration applications, along with professional and business process outsourcing services.
Our executive team includes 40+ years of experience in Healthcare Administration and Technology. This wealth of knowledge powers our holistic thinking and sharp execution.
We practice an open-door policy and are always willing to listen to employee ideas and feedback. At HealthAxis, your ideas and innovations are appreciated and supported.
JOIN OUR TEAM!
We have more than 400 team members nationwide! We are seeking team members who are passionate about technology, service-oriented, positive, driven, enjoy teamwork, and are looking for a casual and inclusive work setting. We are currently seeking a Seasonal Enrollment Specialist.
The Enrollment Specialist is responsible for performing duties related to enrollment of Medicare and Medicaid beneficiaries. Responsible for processing new and or maintenance updates to enrollment eligibility in the membership systems. Demonstrates the skills and ability to analyze information to make appropriate decisions regarding eligibility in compliance with regulations and governance set forth by the Centers for Medicare and Medicaid Services (CMS) and Beacon Health Solutions. The Enrollment Specialist is required to make eligibility determinations based on CMS (Part A/Part B Eligibility) in accordance with the application election period guidelines. To accurately identify appropriate election period based upon analysis of beneficiary/member history and regulatory guidance. Interacts with both internal and external customers to address and resolve inquiries or complaints and achieve CMS requirements and Client’s Service Level Agreements (SLAs). Must adhere to and keep up to date with new regulations and guidance provided during training updates.
PRINCIPAL RESPONSIBILITIES AND DUTIES:
- Ensure the accuracy and timeliness of processing enrollments and disenrollment in compliance within Medicare and Medicaid regulations and Beacon policies and procedures.
- Process daily applications and disenrollment received via the various sources in the membership systems for daily transmission to CMS.
- Assist with daily reviews and processing of the Daily Transaction Reply Report (DTRR).
- Assist with tracking and oversight of CMS OEC, Auto and Facilitated web-based files.
- Research and responds to all internal and external customer inquiries.
- Generate appropriate correspondence to outreach to members request, as necessary.
- Performs root cause analysis to determine issues related to member inquiry and or system errors.
- Initiate phone interactions with members to issue resolution.
- Attention to detail is critical to the success of this position, with skills in customer orientation.
- Accurately enter COB for timely and accurate claims adjudication
- Assist mailroom with processing Return Mail.
- Adhere to productivity, quality, and compliance expectations.
- Identifies issue trends and opportunities for improvement.
- Be a supportive and collaborative team member.
CUSTOMER SERVICE:
- Responsible for driving the HealthAxis culture through values and customer service standards.
- Accountable for outstanding customer service to all external and internal contacts.
- Develops and maintains positive relationships through effective and timely communication.
- Takes initiative and action to respond, resolve and follow up regarding customer service issues with all customers in a timely manner
EXPERIENCE AND REQUIRED SKILLS:
- Demonstrates good organizational, interpersonal, leadership and communication skills.
- Knowledge of Medicare Advantage Guidelines per CMS Chapter 2, and knowledge of transactions between CMS and health plans.
- Excellent oral and written communication skills including good grammar, voice, and diction.
- Able to read and interpret documents.
- Proficient in MS Office with basic computer and keyboarding skills (40wpm).
- Detail oriented and highly organized.
- Excellent customer service skills (friendly, courteous, and helpful).
EDUCATION:
- High school diploma or general education degree (GED) required
- Minimum one-year related experience preferred
- An equivalent combination of education, training, and experience
PHYSICAL DEMANDS AND WORKING CONDITIONS:
The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
1. Ability tofrequentlyremain in a stationary position.
2. Ability to frequently communicate and exchange accurate information.
3. Ability toconstantlyoperate equipment such as telephone, computers, etc.
4. Ability to move equipment more than 5 lbs.
Review and comply with all relevant Company policies and procedures, local, state, and federal laws and regulations. Ensure that employees understand and comply with all-relevant Company policies and procedures, and local, state, and Federal laws and regulations, and establish effective internal systems and controls to promote such compliance.
The duties listed in this job description are intended only as illustrations of the various types of work that may be performed. The omission of specific statements of duties does not exclude them from the position if the work is similar, related, or a logical assignment to the position.
HealthAxis Group is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, pregnancy, sexual orientation, gender identity, national origin, age, protected veteran status, disability status, or membership in any other group protected by federal, state, or local law.