Work in Washington Veterans Jobs

Description:

This position will research and process complex reconciliation of Employer Group, Individual and Family, and Medicare Advantage accounts. Resolve complicated issues pertaining to compliance, State and Federal regulations, Employer Group/Medicare Advantage coordination of benefits. Creates and implements process relating to compliance, Group contracts and other departmental value stream initiatives. May identify, investigate and document all revenue based CMS status codes and beneficiaries, ensuring compliance with CMS regulations. Resolve discrepancies and prepare reports for management, or Employer Groups. Process, track and monitor CMS-related and Employer Group membership requests and actions. Ensure accurate coding of Medicare and Group coverage contracts and CMS-related/Employer Group data in the membership system.

Specifically will be working to enroll members of the postal service health benefit board that are moving into the Medicare group. The team is made up of coordinators, more detail oriented and outside the box thinkers. Candidates will be looking up coverage in MARx and enrolling based on the postal service reformate, they need to separate out postal members from government, so members need to be auto moved over.

Very limited but possible to do enrollment processing to make outbound calls.

Additional Skills & Qualifications:

• Associate's degree OR minimum two (2) years of experience in a directly related field.

• High School Diploma OR General Education Development (GED) is required.

Basic Qualifications

• Existing credit history (how the gov checks ID through credit Bureau) to be able to access MARx systems

• 3-5 years of experience working in an administrative capacity

• Minimum one (1) year of experience in health plan/health insurance department.

• Computer literacy with typing at 40 WPM

• Knowledge of database and MS Office applications, including Excel and Word.

Additional Requirements:

• Experience with membership and billing functions.

Preferred Work Experience

• Four (4) years of health plan experience within a Medicare managed care plan.

• Managed Medicare processing functions with accounting and KFHPW

This is a highly regulated environment that indicates a lot of oversite by CMS - (center for Medicare/Medicaid services) and OPM (office of personnel management).

Work Environment:

REMOTE IN WASHINGTON STATE

Monday-Friday 7 AM - 5 PM PST (8 hour shift)

Training 3 months 7 AM - 3:30 PM

About TEKsystems:

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.