Enrollment Analyst - ACA Enrollment
Home Work - Monongalia County WV (Local), United States
USD 44K-70K (estimate) Mid-level Full Time
Tasks
- Analyze enrollment data and prepare management reports
- Comply with CMS submissions
- Conduct regular compliance audits
- Coordinate with cross functional teams to streamline enrollment
- Develop and deliver trainings
- Maintain enrollment databases and software
- Maintain member record maintenance
- Manage weekly enrollment files
- Monitor enrollment work queues
- Own EDV monthly processes
- Own REED submissions
- Perform monthly reconciliation from CMS
- Process ACA FFM enrollment transactions
- Process LEP data files
- Process MPWR files
- Process Medicare applications daily
- Process SNP applications
- Process Special Enrollment Period requests
- Process and review 834 enrollment transaction files
- Process enrollment cancellations
- Process enrollment maintenance transactions
- Process plan changes
- Process reinstatement transactions
- Reconcile membership and coverage records
- Research and resolve enrollment discrepancies
- Resolve transaction errors rejects exceptions
- Respond to member inquiries about enrollment procedures and benefits
- Run Real Time Eligibility queries
- Validate enrollment data
- Verify eligibility for SNP
Perks/Benefits
- N/A
Skills/Tech-stack
834 enrollment transaction files | ACA | APTC | Acceptance Testing | Administrative Data | Administrative data processing | Advance Premium Tax Credit | CMS | COB | CSR | Coordination of Benefits | Cost Sharing | Cost Sharing Reduction | Customer Service | Data Processing | Data Validation | Data entry | EDV | Eligibility Queries | Enrollment Data Validation | Enrollment data | Enrollment transaction processing | Epic | FFM | Late enrollment penalty | MAPD | MARx | MARx website | Medicare | Medicare Enrollment | Medicare elections | Medicare eligibility | Member record maintenance | Microsoft Access | Microsoft Excel | Microsoft Outlook | Microsoft Word | REED | Real Time | Real Time Eligibility | Real time eligibility queries | Reconciliation | Record Maintenance | Regulatory Compliance | SEP | SNP | Special Enrollment Period | System Testing | Tax Credit | Training delivery | Transaction Processing | Transaction codes | User Acceptance | User Acceptance Testing
Education
Regions
Countries
States
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