The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms.
Reconciliation Specialist is responsible for reviewing and tracking all of Homefirst members' renewal recertification submissions to Human Resources Administration (HRA). Provides and makes plan recommendations on a disenrollment. Identifies new cases from the NY State roster that have changes in eligibility and informs the assigned Enrollment Coordinator. Review the plan's monthly eligibility file for members who may have lost Medicaid eligibility and no longer qualify for MLTCP enrollment.
- Associate's Degree required; Bachelor's Degree, preferred
- Minimum of two years experience in a Managed Care Organization or similar environment.
- At least one year experience reconciling data and payment variances
- Knowledge of Managed Care Organizations, CMS and Federal Regulations; and ability to work in a fast paced environment
- Knowledge of MS Office (Word, Excel, PowerPoint) required
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