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Enrollment and Premium Billing Reconciliation Analyst

Presbyterian Healthcare Services
life insurance, paid time off
United States, New Mexico, Albuquerque
1100 Central Avenue Southeast (Show on map)
Nov 16, 2024

Enrollment and Premium Billing Reconciliation Analyst


Requisition ID
2024-43244

Category
Health Plan Service Operations


Location : Name

Rev Hugh Cooper Admin Center


Location : City

Albuquerque


Location : State/Province

NM

Minimum Offer
USD $19.78/Hr.

Maximum Offer for this position is up to
USD $30.21/Hr.



Overview

Now hiring a Enrollment and Premium Billing Reconciliation Analyst

Support the management of daily operations in the Enrollment and Premium Billing Departments by providing data analytics for all lines of business, Commercial, Medicaid and Medicare. Function as primary contact on technical, workflow and quality issues and primary contact with IT. Develops business reports as required. Performs advanced data analysis and reporting for department.

How you belong matters here.

We value our employees' differences and find strength in the diversity of our team and community.

At Presbyterian, it's not just what we do that matters. It's how we do it - and it starts with our incredible team. From Information Technology to Food Services and beyond, our non-clinical employees make a meaningful impact on the healthcare provided to our patients and members.

Why Join Us

    Full Time - Exempt: Yes
  • Job is based Rev Hugh Cooper Admin Center
  • Work hours: Days
  • Benefits: We offer a wide range of benefits including medical, wellness program, vision, dental, paid time off, retirement and more for FT employees.


Qualifications

  • Associates degree or three to five years related experience in data compilation, analysis, and reporting, utilizing the appropriate tools in lieu of degree. Requires strong organizational, analytical and problem-solving skills, as well as the ability to create, sort and analyze reports.
  • Experience in data problem research, and consistent accuracy and attention to detail is required.
  • Requires strong working knowledge and/or experience with Microsoft Office products and other analytical tools.
  • Prior experience with Business Objects, Crystal, SQL, Facets and Enrollment and/or Premium Billing activities preferred.
  • Must demonstrate ability to work effectively in a team environment; under limited supervision and resolve issues with minimal assistance.


Responsibilities

  • Supports the Enrollment and Premium Billing Operations team with by assisting with workflow planning, establishing business objectives, and goal setting based on the analysis of the open work inventory.
  • Prepares and presents data interpretation and recommendations at a level understood by intended audience; such as coworkers, staff and management
  • Provides support with database development along with the needed infrastructure maintenance.
  • Establishes operational reporting for the Enrollment and Premium Billing Departments
  • Uses established methods, techniques and tools to document and maintain all deliverables created in accordance with departmental policies
  • Serves as liaison between Enrollment and Premium Billing Operations, IT and other departments and systems related to enrollment and Premium Billing functions. Serve as vendor liaison where appropriate.
  • Serves as business expert on electronic eligibility and premium program and processes.
  • Prepares time sensitive data analysis and produces monthly measurement standard reports for internal dashboard/performance reporting.
  • Maintains/Updates regulated letters using Crystal Reporting
  • Responsible for projects and implementations regarding there line of business. In addition to day to day operational duties.
  • Follow document process steps to make decisions, build relationships with clients and work with multiple departments, government agencies and other departments.


Benefits

All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.

Wellness
Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.

Why work at Presbyterian?
As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.

About Presbyterian Healthcare Services
Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.

Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.

Inclusion and Diversity
Our culture is one of knowing and respecting our patients, members, and each other. We capture this in our Promise and CARES commitments.

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.



Maximum Offer for this position is up to

USD $30.21/Hr.


Compensation Disclaimer

The compensation range for this role takes into account a wide range of factors, including but not limited to experience and training, internal equity, and other business and organizational needs.


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