CareFirst Careers

Enrollment & Billing Specialist

Resp & Qualifications

SUMMARY: The incumbent is responsible for assisting leadership and peers with new and ongoing financial reporting, reconcilements, metrics and analysis of premium payments, and all Inbound/Outbound collection campaigns. This position requires the incumbent to possess an ability to work well with people, to communicate clearly in oral and written work, and to possess some leadership and motivational skills. This incumbent must be able to keep department flowing and on target. 

ESSENTIAL DUTIES AND RESPONSIBILITIES include, but are not limited to, the following:
Under the general direction of the EAB AR Manager:

Reviews and distributes reporting for financial reconcilement activities, to include; Applied Suspense, Unapplied Suspense, Account Receivables, Refunds, Dual Enrollment, Voluntary Terms, CD NOC, Discretionary Billing Credits, Escalation Aversion, Non-Sufficient Funds, Membership Voids, Reinstatements and Inbound/ Outbound Credit & Collections campaigns.
• Distributes work objects for error reconciliation from multiple systems.
• Provides analysis and reporting support to leadership. 
• Assists training team with workflow and SOP development and implementation.
• Provides and assists with the coordination of chairside training for new processes and new hires.
• Provides and assists compliance with chairside process audits.
• Assists team with escalated calls or cases related to Collections.

 Analysis and validation of numerical data, posted transactions and reconciled system reports with operating reports.
• Supports daily operations to ensure they run with optimum efficiency to achieve all internal and external corporate goals and objectives.
• Recommends, coordinates and assists with solutions to improve internal operations.

Provides peer to peer support and mentoring to increase quality of business processes and effectiveness.

Other projects and duties as assigned to assist in company, divisional and/or departmental goals.

QUALIFICATION REQUIREMENTS:

REQUIRED EXPERIENCE:

  • High School Diploma.
  • Minimum 5 years of enrollment and billing experience including 2 plus years with reporting and finance experience.
  • Demonstrate strong proficiency within the Credit & Collection, Financial & Reconciliation, and Enrollment & Billing operational unit is required.


SKILLS/ ABILITIES:
Incumbent must have demonstrated a fluency in financial operations. Knowledge of health insurance products and internal business practices is necessary. Strong analytical/problem solving abilities. Extremely well-organized. Demonstrates the ability to achieve results under pressure. Must be able to effectively work in a fast-paced environment with frequently changing priorities, deadlines, and workloads. Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence. Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.

Must have strong analytical and problem resolution skills, strong communication/presentation skills, interpersonal/leadership skills, some project management skills, and be able to motivate.  Must have Intermediate to Advanced Microsoft Excel skills, to include data extraction, workbook linking, formula creation, Macros, v Lookups and Pivot Tables development. Must be exposed to VISIO for workflow creation.

Comprehension and exposure of Project Management.

PREFERRED:

  • Bachelor’s Degree
  • Knowledge of the health insurance industry
  • Ideal experience with CareFirst systems, to include:
    • FACETS 5.01
    • Automated Enrollment, v2 (PEGA)
    • FileNet WorkplaceXT, Enterprise Data Management System
    • Rubi SQL Reporting
    • SharePoint
    • Microsoft Office Suite, Intermediate user to include Microsoft Project and Access
    • VISIO
  • 2+ years of Enrollment and Billing or Credit & Collections TECH III experience, to include Inbound/Outbound Call Center experience.


 

Equal Employment Opportunity

CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer.  It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

Hire Range Disclaimer

Actual salary will be based on relevant job experience and work history.

Where To Apply

Please visit our website to apply: www.carefirst.com/careers

Closing Date

Please apply before: 7.7.21

Federal Disc/Physical Demand

Note:  The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.

PHYSICAL DEMANDS:

The associate is primarily seated while performing the duties of the position.  Occasional walking or standing is required.  The hands are regularly used to write, type, key and handle or feel small controls and objects.  The associate must frequently talk and hear.  Weights up to 25 pounds are occasionally lifted.

Sponsorship in US

Must be eligible to work in the U.S. without Sponsorship

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