Chip Reconciliation Coordinator - Harrisburg, United States - Capital Blue Cross

Capital Blue Cross

Verified Company

Harrisburg, United States

3 weeks ago

Posted by:

Mark Lane

beBee recruiter

Description

Position Description:
At Capital Blue Cross, we promise to go the extra mile for our team and our community.

This promise is at the heart of our culture, and it's why our employees consistently vote us one of the "Best Places to Work in PA.

This position is responsible for supporting the Senior Reconciliation Analyst with the enrollment and financial reconciliation process between the Department of Human Services (DHS) and the Company for CHIP membership.

Primary focus will be to research discrepancies, identify root cause/problem and track activities within the reconciliation process.

Responsibilities and Qualifications:

Maintain an understanding of CHIP payment and reconciliation guidelines and requirements.
Research and resolve billing and enrollment irregularities between DHS and Facets. Resolution may require updating Facets and/or submission updates to Enrollment and Billing.
Submit and track Enrollment and Billing updates to ensure timely completion of enrollment updates.
Submit disputes and validate dispute responses exchanged with the DHS to ensure timely updates of reconciliation data.
Identify and report potential trends to the Senior Reconciliation Analyst.
Interact with DHS including the CHIP Office and County Assistance Offices to resolve reconciliation cases.
Assists CHIP staff on an as needed basis at management's discretion.
Participate in monthly Reconciliation Team Unit meeting to discuss trends identified and resolutions.

Knowledge:

Knowledge of CHIP enrollment and reconciliation files/data including Facets look up, daily 834 file research, review of reconciliation files and analysis of the audit files (monthly 834 file) from DHS.

Skills:

Demonstrated research, analytical, and logic skills.
Strong written and verbal communication skills. Ability to communicate effectively both verbally and in writing.
Demonstrated ability to adapt to changing workload requirements.
Demonstrated ability to work independently and to plan/organize workload.
Ability to handle large volumes of work, solve problems and manage multiple assignments while meeting critical deadlines.

Experience:

Experience with PCbased software packages (Word, Excel, Access, and WorkDESK) to perform research and analysis tasks.
Familiarity with healthcare insurance industry, health delivery systems, and the business environment in which they exist.
Experience with operational processing systems utilized throughout Capital's business operations such as FACETS, eCIS and other CHIP Reconciliation support tools.

Education, Certification, and Licenses:

Associate degree or 2 years of equivalent work experience.

Physical Demands:

While performing the duties of the job, the employee is frequently required to sit, use hands and fingers, talk, hear, and see.
The employee must be able to work over 40 hours per week.
The employee must occasionally lift and/or move up to 5 pounds.

About Us:

We recognize that work is a part of life, not separate from it, and foster a flexible environment where your health and wellbeing are prioritized.

At Capital you will work alongside a diverse and caring team of supportive colleagues, and be encouraged to volunteer in your community.

We value your professional and personal growth by investing heavily in training and continuing education, so you have the tools to do your best as you develop your career.

And by doing your best, you'll help us live our mission of improving the health and well-being of our members and the communities in which they live.