Business Analyst, Enrollment
2.
7 Quick Apply Full-time 8 days ago Full Job Description BUSINESS ANALYST, ENROLLMENT ABOUT US Join us in making a career at Independent Living Systems, an industry leader in managing home and community-based programs for over 20 years.
Independent Living Systems, LLC and its subsidiaries offer a comprehensive range of clinical and third-party administrative services to managed care organizations and providers that serve high-cost, complex member populations in the Medicare, Medicaid, and Dual-Eligible Market.
ILS provides tailored integrated solutions aimed at improving health outcomes while rebalancing costs, addressing social determinants of health and connecting members with community-based resources.
POSITION SUMMARY This position is responsible for maintaining the enrollment data for all clients.
Focus on the accuracy and integrity of all Medicaid and Medicare specific data as well as client and other regulatory requirements.
Additional responsibilities include working with the Director and Manager on key audits and Quality Assurance measures.
POSITION RESPONSIBILITIES AND ACCOUNTABILITY Process the enrollment, disenrollment and maintenance of all Medicaid, and Medicare membership for all plans.
Run programs and conduct membership reconciliation for Medicaid/Medicare products.
Responsible for the timely completion of all eligibility updates.
Responsible for the submission of regulatory files to DOH and CMS.
Responsible for the completion of PCP panel transfers with letters to members as necessary.
Run and QA ID cards.
Data enter applications as needed.
Complete special projects as needed.
Assist in writing department policies and procedures and workflows for all plans and processes.
Work closely with management and eligibility staff to ensure all departmental tasks are completed.
Assist management with implementation of new clients.
Assist with training of new employees.
Assist in the quality assurance process.
Assist in the development of quality assurance processes for new clients and new functions.
POSITION QUALIFICATIONS Bachelors or Associates degree and/or equivalent work experience required.
Minimum of two years with Medicaid and/or Medicare eligibility experience.
Excellent written, verbal and grammatical communication skills required.
Ability to read, interpret, analyze technical / business procedures and / or governmental regulations required.
Ability to write reports, business correspondence and procedural manuals required.
Knowledge of automated systems (technical adeptness) required.
Demonstrated proficiency in Microsoft programs (ie, Excel, Word, PowerPoint) required; knowledge of Microsoft Access preferred.
Job Type:
Full-time Pay:
$1.
00 per hour
Benefits:
401(k) 401(k) matching Dental insurance Health insurance Life insurance Paid time off Vision insurance Schedule:
8 hour shift Monday to Friday Ability to commute/relocate:
Miami, FL 33166:
Reliably commute or planning to relocate before starting work (Required)
Experience:
Medicaid and/or Medicare eligibility:
2 years (Required) Processing enrollment, of Medicaid, and Medicare membership :
2 years (Preferred) Processing disenrollment , of Medicaid, and Medicare:
2 years (Preferred) submission of regulatory files to DOH and CMS:
1 year (Preferred) Work Location:
One location 401(k) 401(k) matching Dental insurance Health insurance Life insurance Paid time off Vision insurance 8 hour shift Monday to Friday Miami, FL 33166:
Reliably commute or planning to relocate before starting work (Required) Medicaid and/or Medicare eligibility:
2 years (Required) Processing enrollment, of Medicaid, and Medicare membership :
2 years (Preferred) Processing disenrollment , of Medicaid, and Medicare:
2 years (Preferred) submission of regulatory files to DOH and CMS:
1 year (Preferred) Quick Apply.
Estimated Salary: $20 to $28 per hour based on qualifications.
7 Quick Apply Full-time 8 days ago Full Job Description BUSINESS ANALYST, ENROLLMENT ABOUT US Join us in making a career at Independent Living Systems, an industry leader in managing home and community-based programs for over 20 years.
Independent Living Systems, LLC and its subsidiaries offer a comprehensive range of clinical and third-party administrative services to managed care organizations and providers that serve high-cost, complex member populations in the Medicare, Medicaid, and Dual-Eligible Market.
ILS provides tailored integrated solutions aimed at improving health outcomes while rebalancing costs, addressing social determinants of health and connecting members with community-based resources.
POSITION SUMMARY This position is responsible for maintaining the enrollment data for all clients.
Focus on the accuracy and integrity of all Medicaid and Medicare specific data as well as client and other regulatory requirements.
Additional responsibilities include working with the Director and Manager on key audits and Quality Assurance measures.
POSITION RESPONSIBILITIES AND ACCOUNTABILITY Process the enrollment, disenrollment and maintenance of all Medicaid, and Medicare membership for all plans.
Run programs and conduct membership reconciliation for Medicaid/Medicare products.
Responsible for the timely completion of all eligibility updates.
Responsible for the submission of regulatory files to DOH and CMS.
Responsible for the completion of PCP panel transfers with letters to members as necessary.
Run and QA ID cards.
Data enter applications as needed.
Complete special projects as needed.
Assist in writing department policies and procedures and workflows for all plans and processes.
Work closely with management and eligibility staff to ensure all departmental tasks are completed.
Assist management with implementation of new clients.
Assist with training of new employees.
Assist in the quality assurance process.
Assist in the development of quality assurance processes for new clients and new functions.
POSITION QUALIFICATIONS Bachelors or Associates degree and/or equivalent work experience required.
Minimum of two years with Medicaid and/or Medicare eligibility experience.
Excellent written, verbal and grammatical communication skills required.
Ability to read, interpret, analyze technical / business procedures and / or governmental regulations required.
Ability to write reports, business correspondence and procedural manuals required.
Knowledge of automated systems (technical adeptness) required.
Demonstrated proficiency in Microsoft programs (ie, Excel, Word, PowerPoint) required; knowledge of Microsoft Access preferred.
Job Type:
Full-time Pay:
$1.
00 per hour
Benefits:
401(k) 401(k) matching Dental insurance Health insurance Life insurance Paid time off Vision insurance Schedule:
8 hour shift Monday to Friday Ability to commute/relocate:
Miami, FL 33166:
Reliably commute or planning to relocate before starting work (Required)
Experience:
Medicaid and/or Medicare eligibility:
2 years (Required) Processing enrollment, of Medicaid, and Medicare membership :
2 years (Preferred) Processing disenrollment , of Medicaid, and Medicare:
2 years (Preferred) submission of regulatory files to DOH and CMS:
1 year (Preferred) Work Location:
One location 401(k) 401(k) matching Dental insurance Health insurance Life insurance Paid time off Vision insurance 8 hour shift Monday to Friday Miami, FL 33166:
Reliably commute or planning to relocate before starting work (Required) Medicaid and/or Medicare eligibility:
2 years (Required) Processing enrollment, of Medicaid, and Medicare membership :
2 years (Preferred) Processing disenrollment , of Medicaid, and Medicare:
2 years (Preferred) submission of regulatory files to DOH and CMS:
1 year (Preferred) Quick Apply.
Estimated Salary: $20 to $28 per hour based on qualifications.
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