Eligibility Associate Representative (33854234)

Responsibilities:

3+ years’ Healthcare Experience, required

3+ years’ experience with Medicare Part A & B, required

Delivers specific delegated Eligibility tasks assigned by a supervisor. Implements, updates, and maintains automated, direct connect and/or manual eligibility data.

May handle reconciliation for non-standard requests. May provide technical support for the electronic procession of eligibility.

Ensures customer data is installed accurately and timely.  Technical knowledge of manual and automated eligibility.

Completes day-to-day Eligibility tasks without immediate supervision, but have ready access to advice from more experienced team members.

Tasks involve a degree of forward planning and anticipation of needs/issues.

 

ESSENTIAL FUNCTIONS

3+ years’ Healthcare Experience, required

3+ years’ experience with Medicare Part A & B, required

Facilitates accurate processing of Enrollment applications to ensure timely input and acceptance to CMS.

Performs account benefit verification requiring complex decision skills based on payer and process knowledge resulting in proper access to care.

Process Reconciliation files from CMS to include Disenrollments, Late Enrollment Penalties and Low Income Subsidies

Timely and Accurate processing of monthly Premium payments including identification and processing of write offs, resolution of credit balances and posting of payments to member accounts

Process Coordination of Benefits and Medicare Secondary Payer files from CMS to meet Federal and State Regulatory guidelines.

Ensure accuracy of data entry to allow for meeting proper Service Level Agreements

Use discretion & independent judgement in handling more complex cases and be willing to learn new skills within the Enrollment Functions

Directly interfaces with other teams within Cigna

Provide support to other internal functions as needed.

May need to be proficient in Multiple Systems

Completes other projects and additional duties as assigned.

 

Skills

3+ years’ Healthcare Experience, required

3+ years’ experience with Medicare Part A & B, required

Technical and Computer Skills required

Basic to intermediate level Excel, required

Analytical skills

Customer Service Skills

Quick Learner

Knowledge of CMS Enrollment & Reconciliation process

Knowledge of CMS Billing requirements and regulations

Knowledge in Coordination of Benefits and Medicare Secondary Payer

Medicare Part C and Part D

Health care experience with medical insurance knowledge and terminology and experience in patient access preferred.

Intermediate data entry skills and working knowledge of Microsoft Office.

Excellent presentation and communication skills.

Demonstrated ability to handle challenging interactions in a professional manner.

Ability to adapt in a dynamic work environment and make decisions with minimal supervision.

Advanced problem solving skills and the ability to work collaboratively with other departments to resolve issues with innovative solutions

SQL (a plus not required)

Education

High school diploma or GED required, bachelor’s degree preferred.

3+ years of relevant working experience.

Location & Schedule:

This is a fully remote position, open to candidates in the US

M-F: 8:30am – 5:00pm    EST Schedule REQUIRED

The pay range that Magnit reasonably expects to pay for this position is: $18.00.-18.00/hr

Benefits: Medical, Dental, Vision, 401K (provided minimum eligibility hours are met)

• Work Authorization :Green Card, US Citizen
• Preferred years of experience :1+ Years
• Travel Required :No travel required
• Shift timings:M-F 8:30am-5:00pm EST