• Job Description

  Req#: R018763
  The Enrollment & Billing Specialist (EBS) is responsible for enrolling new and renewing existing Healthfirst members into the Healthfirst Managed Healthcare System in an accurate and timely fashion. The EBS processes all member payment information, responds to member inquiries and performs account analysis.

  **This position is Remote

  Duties and Responsibilities Include:

  • Maintain daily production and quality requirements to meet the department Service Level Agreement
  • Processes enrollment applications received on a daily basis
  • Completes eligibility screens and routes appropriately for timely submission to Local Departments of Social Services
  • Ensure Quality Assurance and Integrity Forms are complete and accurate prior to transmitting the application for data entry
  • Verifies prospective member eligibility and enrollment history through systems to include ePaces and Member Health Services (MHS)
  • Process and perform quality control measures on enrollment and disenrollment transactions and billing activities
  • Ensures applications are labeled correctly and routed out of data management system timely and accurately
  • Review and analyze eligibility and billing reports to ensure members are properly enrolled and premium payments correctly applied to accounts
  • Partner with Member Services and other departments to address and resolve member issues within the expected timeframes
  • Process payments and refunds, updating members’ accounts to reflect changes
    Additional duties and special projects as assigned

  Minimum Qualifications:

  • High School diploma or GED equivalent from an accredited institution
  • Work experience of multitasking between programs, data entry or client look up systems
  • Experience working with multiple Microsoft Excel worksheets including filtering and updating information on a daily basis
  • Experience using Microsoft Outlook including email, tasks and calendar functions
  • Experience using Microsoft Word for creating letters, memos and general correspondence
  • Experience with business process and customer relationship management systems
  • Ability to work overtime as the business requires

  Preferred Qualifications:

  • Bachelor’s degree from accredited institution
  • Ability to solve problems and find solutions
  • Effective verbal and written communication skills
  • Previous auditing or analytical experience
  • Experience with data mining, report analysis or reconciliation experience within a healthcare billing or commercial insurance environment
  • Experience with Microsoft Access as a database management system
  • Experience reviewing, approving and processing applications or member records
  • Experience with reviewing New York State Medicaid/Medicare Health Plans

  Compliance & Regulatory Responsibilities: NA

  License/Certification: NA

  WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

  If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798 . In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within Healthfirst Management Services will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with Healthfirst Management Services.

  EEO Law Poster and Supplement

  All hiring and recruitment at Healthfirst is transacted with a valid “@healthfirst.org” email address only or from a recruitment firm representing our Company. Any recruitment firm representing Healthfirst will readily provide you with the name and contact information of the recruiting professional representing the opportunity you are inquiring about. If you receive a communication from a sender whose domain is not @healthfirst.org, or not one of our recruitment partners, please be aware that those communications are not coming from or authorized by Healthfirst. Healthfirst will never ask you for money during the recruitment or onboarding process.

  Hiring Range*:

  • Greater New York City Area (NY, NJ, CT residents): $47,403 - $62,400

  • All Other Locations (within approved locations): $41,101 - $60,320

  As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.

  In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.

  *The hiring range is defined as the lowest and highest salaries that Healthfirst in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role.

• About the company

  Healthfirst health insurance gives you access to a large network of doctors and hospitals and access to the care you need, when you need it. Learn more now.

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