Company Statement

ConnectiCare is a leading health plan in the state of Connecticut. ConnectiCare’s mission is to make it easy for members to get the care they need. A local company for over 35 years, ConnectiCare has a full range of products and services for businesses, municipalities, individuals and those who are Medicare-eligible. A subsidiary of EmblemHealth, ConnectiCare leads the individual and small group markets in the state, and is ranked among the top commercial health plans in the nation, according to the National Committee for Quality Assurance.

We’re looking for individuals who want to make a difference in the communities we serve. If you want to join a local team and help change the way health care is delivered, ConnectiCare is the place for you.

Manager, Revenue

🔍 New York, New York, United States

Hot

📁: Manager & Professional

💼: EmblemHealth

📅   : Nov 08, 2018 Post Date

The Manager will plan, organize and direct all aspects of the functions to ensure timely, legally compliant and accurate billing while maximizing the cash flow related to the collections of Accounts Receivables for Large Groups through monthly reconciliations. Ensure the members have access to care. Provide World Class Service to our clients. This position interfaces heavily with external clients, Account Management, Finance and the Enrollment & Billing Vendors.

Responsibilities:

Supervise a team responsible for the enrollment and payment reconciliation of the largest Emblem clients (e.g. Fed, NY State, NY City) to Identify discrepancies and drive for resolution. Leveraging technology, the team of data analysts will perform systemic compares of the client’s membership file supporting their payment to Emblem’s membership membership records. The team will identify members that are active with Emblem Health but not included in the client’s payment; on the Clients Records but not active with Emblem Health; benefit; contract type and other discrepancies would be noted and need to be resolved.
Partner with Account Management to communicate with the clients on discrepancies / trends and with Finance to align on objectives for revenue cycle management. Work with all internal customers to establish competency. Identify Have a clear understanding of the EDI process, providing direction/suggestions to the clients and vendors to ensure smooth processing of the enrollment.
Act as a liaison between Emblem Health, the Clients (NYS, City and Feds) and vendor for enrollment processing Identify members that the vendor missed when processing terminations or adds.from the EDI File.
Monitor timely and accurate payments from the clients, track Accounts Receivable balances and develop, implement and maintain collection policies, procedures and processes with appropriate controls and checks and balances. Follow-up with Account Management/Client on outstanding reconciling items that remain unresolved. Provide recommendations with data points to Sr. Leadership on next steps for outstanding accounts receivable balances.
Champion, coordinate and implement process and technical improvements for the EDI enrollment exchanges.

Qualifications:

Bachelor’s Degree
5-8 years of experience
Experience training and troubleshooting within health care and managed care business specialty area in finance, and office management, preferred
Commercial Healthcare experience a+
Self-starter with strong problem solving acumen with critical thinking and analytical skills
Background in 834 EDI Processing
Proficiency in Microsoft Office, Excel, Access and Data Analytics
Supervisory experience

EEOC Statement

We are committed to leveraging the diverse backgrounds, perspectives and experiences of our workforce to create opportunities for our people and our business. We are an equal opportunity/affirmative action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or any other characteristic protected by law.

Company Statement

Manager, Revenue

🔍 New York, New York, United States

EEOC Statement

Similar Listings