Enrollment analyst - united states, longview (washington)

the enrollment analyst i supports the enrollment manager/enrollment supervisor in the investigation and resolution of complex enrollment issues, in accordance to thp’s district contract guidelines. this role ensures that these issues are resolved within the mandatory guidelines as established by state and federal regulatory agencies and in accordance with thp policy.

principal accountabilities:
§ facilitate and/or assist with the automated enrollment process , including automated monthly loads, member reconciliation, member notifications, including newborn enrollments, presumptive newborn dis-enrollments and long term care dis-enrollment requests.
§ identify any abnormalities in the enrollment process.
§ review and reconcile daily, weekly reconciliation reports.
§ perform and/or assist with the pcp changes due to provider terminations and maximum provider panel closings.
§ prepare documentation for the district health care finance office to include out of state report, incarcerated members report, long term care dis-enrollment request.
§ qa all submissions to dhcf.
§ validate and update district tpl/cob in mhc.
§ assist enrollment manager with review of enrollment desk level procedures/standard operating procedures and recommend updates to align with current processes and procedures.

necessary qualifications:
required experience/skills/abilities:
§ a minimum of one (1) year of membership enrollment experience
§ experience working with health care benefits, medicaid or medicare. dc medicaid is a plus.
§ ability to exercise exceptional judgment in decision-making, prioritize tasks to meet deadlines, exceptional multi-tasking skills and problem solving skills
§ proficient in microsoft office tools (outlook, word, excel, powerpoint)
§ ability to analyze 834 files.
§ ability to work independently with limited supervision as well as in a team environment
§ managed care experience preferred
§ knowledge of principles and practices of the managed health care systems, and medical administration and ncqa accreditation standards preferred
§ mhc preferred

education/certifications:
§ high school diploma or ged
§ associate degree preferred

what’s in it for you:

pay rate: $24.30/hr.

start date: 10/31/2022

5 week training period- remote, monday-friday 8:30am-5:00pm et

schedule: monday-friday, 40 hours per week

flexible schedule after training- choose to start at 7am, 8am, or 9am!

temporary to permanent position after 6 months

hybrid role- commute required 1-2 days per month to 1100 new jersey ave se, washington, dc 20003 (will have advanced notice of days required)

equipment required- windows 7 or greater os on laptop or desktop computer, high speed internet

adecco associate benefits plan eligible after first 40 hours on assignment

equal opportunity employer/veterans/disabled



the company will consider qualified applicants with arrest and conviction records

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