Job Description
Medicaid Enrollment
Team Lead
Responsibilities May Include But Are Not Limited To
- Process daily enrollee invoices and premium reconciliation for Marketplace members.
- Perform month-end invoicing and accuracy audits.
- Administer claims payments, maintain claim records, and provide counsel to claimants regarding coverage amount and benefit interpretation.
- Monitor and control backlog and workflow of claims and ensure that claims are settled in a timely fashion and in accordance with cost control standards.
- Assist in resolution of escalated premium payment issues with Appeals and Grievances team.
- Guide and collaborate with Enrollment team to resolve eligibility issues affecting premium billing.
- Ensure the accurate billing and posting of payments on accounts.
- Complete adjustments for bad debt accounts and is responsible for timely correction of posting errors.
- Verify, document and investigate the presence of health care coverage for Medicaid recipients and their families.
- Assist in the identification of members that may qualify for the HIPP/Premium Assistance program.
- Complete maintenance of active cases during open enrollment and premium review for check processing to assist with maintaining the revenue and program growth.
- Partner with enrollment teams and offer guidance where premiums are directly impacted by enrollment discrepancies.
Location for this position is Phoenix, AZ.
Qualifications
Basic
- High School Diploma or GED Equivalent
- At least 4 years of relevant work experience
Preferred
- Knowledge of basic Medicaid/Medicare billing rules, regulations, and deadline
- Must have excellent time management and organizational skills.
- Strong team-oriented individual.
- Excellent communication with all levels of team.
- Must have strong knowledge and experience in MS office products, minimally Outlook, Word and Excel.
- Access or SQL experience is a plus.
Note: Applicants for employment in the U.S. must possess work authorization which does not require sponsorship by the employer for a visa (H1B or otherwise).
The job entails sitting as well as working at a computer for extended periods of time. Should be able to communicate by telephone, email or face to face.
About Us
Infosys BPM, the business process management subsidiary of Infosys (NYSE: INFY), provides end-to-end transformative services for its clients across the globe. The company’s integrated IT and BPM solutions approach enables it to unlock business value across industries and service lines, and address business challenges for its clients. Utilizing innovative business excellence frameworks, ongoing productivity improvements, process reengineering, automation, and cutting-edge technology platforms, Infosys BPM enables its clients to achieve their cost reduction objectives, improve process efficiencies, enhance effectiveness, and deliver superior customer experience.
Infosys BPM has 32 delivery centers in 16 countries spread across 6 continents, with more than 38000 employees from over 80 nationalities, as of Nov 2019.
The company has been consistently ranked among the leading BPM companies globally and has received over 60 awards and recognitions in the last 5 years, from key industry bodies and associations like the Outsourcing Center, SSON, and GSA, among others. Infosys BPM also has very robust people practices, as substantiated by the various HR-specific awards it has won over the years. The company has consistently been ranked among the top employers of choice, on the basis of its industry leading HR best practices. The company’s senior leaders contribute widely to industry forums as BPM strategists.