Examiner

• Resolve complex enrollment and billing reconciliation issues between the Health Plan and external customers, including State and Federal Government Agencies
• Reconcile regulatory and Health Plan Enrollment data through audit and review
• Verify enrollment and billing accuracy to ensure the plan is paid correctly and maintain accurate financial records
• Complete member and/or group documentation and transactional updates to reconcile account discrepancies
• Investigate, analyze, track, and monitor operational issues identified during financial balancing adjustment of funds
• Participate in process and technology improvement efforts
• Prepare regular and periodic operational reports of transactions
• Initiate requests to other operational areas to resolve problems or recommend process improvements
• Communicate with internal and external customers, provide supporting documentation, and recommend procedure changes
• Process inventory from other lines of business as requested
• Level II: Mentor and collaborate with team members, share best practices, and review work
• Level II: Serve as a subject matter expert and support implementation of new processes and procedures
• Level II: Create test cases, test processes, conduct end-user testing, create documents, and establish procedures
• Level II: Represent Enrollment Resolution on corporate projects and cross-functional work groups

Explore Enrollment Resolution Examiner I at LTHC. Review requirements and application details.