What are the responsibilities and job description for the Junior QA Healthcare Analyst position at SheJobs-Diversity Focused Organization?
Key Responsibilities
- Application Processing: Accurately input new enrollment applications, renewals, and modifications into company and government systems, such as the Medicare Online Enrollment Center (OEC).
- Eligibility Verification: Review applicant information to verify eligibility requirements are met, identifying gaps in documentation.
- Member Communication: Act as a liaison to beneficiaries or providers to answer questions, obtain missing information, and confirm enrollment status.
- Compliance and Reporting: Ensure all actions comply with CMS guidelines; generate reports to identify, track, or fix enrollment errors.
- Record Maintenance: Maintain and update sensitive member data and documentation, including NPI files and Medicare 855A forms
Required Skills and Qualifications
- Knowledge: Understanding of Medicare parts A/B/D, Medicare Advantage, and Medicaid eligibility.
- Technical Skills: Proficiency in Microsoft Office (Excel) and database management software. Preferably experience in Market Prominence, HRP
- Administrative Skills: Exceptional data entry, attention to detail, and ability to manage high-volume paperwork.
- Communication: Strong verbal and written skills for communicating with seniors or providers
Typical Experience
- 1–3 years in health insurance, enrollment, or administrative roles within healthcare.
- High school diploma or equivalent; higher education is often preferred