Responsible for preparation, processing and maintenance of new members and re-enrollment. Processes and maintains health plan's member and enrollment records, employer's monthly reports, sending membership cards and materials. Verify enrollment status, make changes to records, research and resolve enrollment system rejections. Address a variety of enrollment questions or concerns received via claims, call tracking, or e-mail. Maintain records in the enrollment database.
Knowledge/Skills/Abilities
Holds general oversight of enrollment and premium staff at each plan site within defined region. This may include employee reviews, coaching sessions and disciplinary actions.
Monitors and enforces compliance with company-wide reconciliation processes.
Ensures that delivery of enrollment / premium related data is accurate for defined region.
Subject matter expert for projects and / or new business related to areas of oversight.
Oversees maintenance of policies and standard operating procedures.
Job Qualifications
Required Education
Graduate Degree or equivalent combination of education and experience
Required Experience
7-9 years
Preferred Experience
10+ years with Medicare enrollment.
Experience with CMS regulations.
Medicare processing experience.
Wipro Member360.
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $87,568.7 - $189,732.18 / ANNUAL
Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Seniority level
Mid-Senior level
Employment type
Full-time
Job function
Education and Training
Industries
Hospitals and Health Care
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