- CalPERS retirement
- 457(b) option with a contribution match
- Generous paid time off- vacation, holidays, sick
- State of the art fitness center on-site
- Medical Insurance with Dental and Vision
- Paid life insurance for employees with additional options
- Short-term, and long-term disability options
- Pet care insurance
- Flexible Spending Account Health Care/Childcare
- Wellness programs that promote a healthy work-life balance
- Career advancement opportunities and professional development
- Competitive salary with annual merit increase
- Team bonus opportunities
- Four (4) years of experience in a managed care setting with at least two (2) years of eligibility research experience required
- Four (4) years of Member Data Configuration or experience working with Eligibility data required
- Experience demonstrating excellent organizational, time management, facilitation, and negotiation skills required
- Experience demonstrating initiative and self-direction with the ability to work well independently and in teams while serving as a Subject Matter Expert (SME) required
- Supervisory/lead capacity experience required
- Two (2) years of Accounts Receivables (AR) experience preferred
- Experience with Covered CA or other Exchange products preferred
- Experience with call center operations preferred
- Knowledge of Medi-Cal and CCA eligibility required
- Knowledge of eligibility file processing required
- Knowledge of managed care operations required
- Knowledge of CCA, DMHC, NCQA rules and regulations preferred
- Knowledge of file format including codes and guidelines preferred
- Bilingual Spanish/English verbal skills preferred
- Ability to navigate enrollment, eligibility, payment/billing, and other backend systems
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Supervisor, Eligibility - Rancho Cucamonga, United States - Inland Empire Health Plan
Description
Overview:
What you can expect
Find joy in serving others with IEHP We welcome you to join us in healing and inspiring the human spirit and to pivot from a job opportunity to an authentic experience
Under the direction of the Manager of Business Systems Operations, the Supervisor, Eligibility & Payment Services is responsible for managing the daily operations and processes of the Eligibility & Payment Services team, including the delegation of duties, task assignments, and projects to maintain timeliness and inventory. The primary functions of this position include but are not limited to, identification, research & reconciliation of premium billing payments to ensure appropriate payment allocation, eligibility processing including enrollment, disenrollment corrections and retroactivity, outreach to members to advice on payment delinquency and resolution options for the Covered CA line of business.
The Supervisor acts as a subject matter expert for the business areas by leading the efforts related to Covered CA eligibility and premium billing.
The Supervisor, Eligibility & Payment Services will contribute to the system build efforts, maintain comprehensive documentation of business and technical specification requirements. The Supervisor will facilitate communication and formally report findings to various department leaders in a manner that is appropriate to the skill level and technical expertise of the audience.
Additional Benefits:Perks
IEHP is not only committed to healing and inspiring the human spirit of our Members; we also aim to match our Team Members with the same energy by providing prime benefits and more.
Education & Experience
Key Qualifications
The work location for this position is classified as "telecommute." Telecommute Team Members must be available and willing to work at an onsite IEHP location when requested or as needed.
Start your journey towards a thriving future with IEHP and apply TODAY
Pay Range:USD $ USD $44.74 /Hr.
