Enrollment Coordinator Senior

Senior Enrollment Coordinator is responsible for completing monthly enrollment and premium reconciliation processes timely and accurately each month as a condition of participation in the Federally Facilitated Marketplace (FFM) Individual Market product.

Assists Lead Coordinator with interpreting CMS guidance and translating to department policies and procedures to support reconciliation activities. Must have good understanding of individual market enrollment process through the FFM and direct enrollments and understands the premium billing and payment collection process.

Interacts with various internal departments: Individual Market Operations Enrollment and Premium teams and external departments including Information Services, EDI and Customer Service. Supports team with questions and training activities. Ensures all team members are tracking their work in the designated tools. Assists Lead Coordinator with monthly reporting. Assists Lead Coordinator with monitoring reconciliation vendor.

Must demonstrate analytical/problem solving skills. Ability to communicate clearly and concisely with team and managers.

• Works with Reconciliation vendor to load RCNO data accurately and provide reports for reconciliation team to review
• Validates identified discrepancies are either corrected in the source system (Facets) or disputed with CMS
• Reviews and tracks all dispute responses and conducts follow up on outstanding issues
• Conducts root cause analysis on high volume errors and proposes and develops solutions
• Participates with CMS Account Managers on reconciliation and other CMS data issues
• Develops and maintains statistics on reconciliation errors
• Assists with annual payment attestation review
• Assists with documenting processes and procedures as applicable
• Assist with managing all CMS reports and development of actions required
• Monitor the pre-audit files received from CMS for missing enrollments
• Educates team on data reconciliation process
• Proficient with Microsoft Office

Required

• High School Diploma or equivalent
• 5 years of relevant experience in related field

Preferred

• Associates Degree or equivalent
• 1 year of experience with Enrollment
• Working knowledge of Facets, state and CMS requirements
• Familiar with Enrollment 834 EDI transaction format
• Ability to understand CMS technical requirements and file output requirements
• Ability to run reports in many applications including vendor specific tools and business objects

As a team member at Corewell Health, you will play an essential role in delivering personalized health care to our patients, members and our communities. We are committed to cultivating and investing in YOU. Our top-notch teams are comprised of collaborators, leaders and innovators that continue to build on one shared mission statement - to improve health, instill humanity and inspire hope. Join a nationally recognized health system with an ambitious vision of continued advancement and excellence.

• Comprehensive benefits package to meet your financial, health, and work/life balance goals. Learn more here.

• On-demand pay program powered by Payactiv

• Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more!

• Optional identity theft protection, home and auto insurance, pet insurance

• Traditional and Roth retirement options with service contribution and match savings

• Eligibility for benefits is determined by employment type and status

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Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief.

Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.

An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team.

You may request assistance in completing the application process by calling 616.486.7447.