What are the responsibilities and job description for the Discrepancy Resolution Specialist position at LaborFirst?
Responsible for activities related to insured member eligibility, enrollment, and member onboard communication, which includes eligibility data file and case management to ensure processed updates are accurate and compliant with Centers for Medicare and Medicaid (CMS) with standardized internal/external required formats.
Role Responsibilities:
- Processes initial eligibility and updates according to client and/or carrier specifics
- Handles and manipulates data files in excel, txt, and other formats with adherence to information security and best practice processes for data file loading integrity
- Quality checks eligibility and enrollment updates and member communications to ensure seamless onboarding experience and CMS compliance
- Communicate clearly through multi-channels on actions taken, next actions and status to support transparent understanding of eligibility and enrollment progress
- Develops, evaluates and modifies processes and best practice methodologies at client and carrier levels to support continuous improvement
- Responsible for data integrity in all manners of eligibility and enrollment processing
- Adheres to strict policies and procedures, as our processes require CMS and carrier compliance
- Interacts with members when needed to support enrollment or disenrollment processing
Required:
· Experience working with Insurance Carriers
· 3-5 years of related customer service experience
· Exceptional attention to detail
· Health Producer’s License (Within 9 months of onboarding). If internal candidate, you must already have health producers license
· High School Diploma or Equivalent
· Intermediate Knowledge of Microsoft Excel and Data Management
Pay: $40,000.00 - $60,000.00 per year
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
Application Question(s):
- Do you have experience working with insurance carriers?
- Do you have at least 3 years of customer service experience?
Work Location: In person
Salary : $40,000 - $60,000