Responsible for the management of the billing, collecting, post payment review, credit balances and correspondence functions of all member accounts. This position is responsible for managing and coordinating team efforts toward a specific service delivery function of the health plans. The position provides coaching, feedback, and corrective action to health plan associates where needed. Responsible for assuring that standard process discipline is followed and assures that high performance work team is developed through coaching, mentoring and daily team briefings.
Responsible for preparing, processing and maintaining new member or group enrollments.
Oversees the loading of new member or group data into the appropriate system.
Oversees the call center, monitoring calls related to member eligibility or group questions and verify enrollment status.
Responsible for reconciling eligibility discrepancies, analyzing transactional data and submitting retroactive eligibility changes.
Supervises staff in their daily job functions to ensure the enrollment process is completed within the regulatory and quality standards
Meet and exceed department quality audits and provide coaching to team members
Maintain and prioritize eligibility discrepancies, analyzing transactional data and responding appropriately
Oversees internal enrollment agents, trains and supervises agents on the enrollment process
Handle all escalations courteously, politely and professionally
Act as back-up support for other managers as needed for meetings and other departmental responsibilities
Perform other duties as assigned
College degree and/or minimum of 5 years healthcare supervisory experience.
Demonstrated success with building and guiding a team to develop and monitor enrollment and eligibility functions within the health plan
General insurance license in all CHRISTUS Health Plan states
CHRISTUS HEALTH is an international Catholic, faith-based, not-for-profit health system comprised of almost more than 600 services and facilities, including more than 60 hospitals and long-term care facilities, 350 clinics and outpatient centers, and dozens of other health ministries and ventures. CHRISTUS operates in 6 U.S. states, Colombia, Chile and 6 states in Mexico. To support our health care ministry, CHRISTUS Health employs approximately 45,000 Associates and has more than 15,000 physicians on medical staffs who provide care and support for patients. CHRISTUS Health is listed among the top ten largest Catholic health systems in the United States.