Enrollment Services - Reconciliation Specialist 160-1012

JOB SUMMARY:

Ensure integrity of member enrollment data and investigate and resolve complex and exception errors. Duties include identifying potential changes in eligibility, seeking verification of changes and disseminating enrollment information to complete the reconciliation.

KEY RESPONSIBILITIES:

• Monitors accounts receivable balances by comparing payment/adjustment reports to eligibility (both CMS & CCOK) to identify discrepancies by member. 
• Prepare discrepancy reports for each account, communicating directly with the various contact for verification. Maintaining the files for each account, both the hard copies and electronic copies.
• Coordinates interdepartmental personnel involved in creating billing transactions to reflect the discrepancies verified as actual terminations, enrollments or premium changes. Verifying that transactions documented to be made were made by the appropriate persons.
• Performs other duties as assigned.

QUALIFICATIONS:

• Must possess strong working knowledge of accounting principles.
• Proficient in Microsoft applications.
• Ability to work on multiple projects concurrently.
• Strong problem solving & critical thinking skills.
• Possess strong oral and written communication skills.
• Successful completion of Health Care Sanctions background check.

EDUCATION/EXPERIENCE:

• High school diploma or equivalent; Associate degree preferred.
• One to three years of previous working experience in accounting, benefits or similar function; preferably in a healthcare environment.