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Medicare Billing and Reconciliation Associate

| Waltham
A bit about us:
We’re on a mission to change healthcare — how it’s paid for, delivered, experienced. We want to put people center stage, not process or profit. We are guided by a deep belief that every person on Medicare should be treated like we would treat a member of our own family: with loving care and a profound commitment to their health and well-being.
That’s why we’re gathering a whole bunch of smart, big-hearted people to create a new kind of healthcare company — one that combines compassion, health insurance, clinical care, and technology seamlessly.
We want to throw the long ball with people we love for a cause we believe in. Life is short. Join us.
A bit more about this role:
Want to work with talented people committed to improving Healthcare? You found the right organization.
The Medicare Billing and Reconciliation Associate is responsible for performing reconciliation of Medicare enrollment membership and premium billing. This role reviews Devoted Health enrollment data and reports received from Centers for Medicare and Medicaid Services to identify and resolve data discrepancies and ensure integrity of member records. This role also supports the enrollment team with processing new enrollment applications and maintaining member enrollment records.

Responsibilities will include:

  • Reviews monthly CMS reports: Monthly Membership Report, Transaction Reply Report, Plan Payment Report and Premium withholding reports. Compares reports to internal eligibility reports and resolves any discrepancies
  • Prepare, review and send member invoices
  • Receive, process and reconcile member premium payments
  • Accurate and timely entry of enrollment applications in Devoted Health’s enrollment system for new enrollees
  • Process member updates in Devoted Health’s enrollment to ensure alignment with CMS records
  • Meet accuracy and timeliness requirements for processing enrollment transactions
  • Work with team to ensure Devoted Health’s membership records are reconciled and is in full agreement with CMS’s records
  • Use enrollment system ques and workflows to address enrollment rejections and resolve errors as identified
  • Assist Team Lead in the collection of enrollment data for CMS monthly reporting
  • Use mail and documentation management systems and workflows for scanning and storing enrollment correspondence
  • Makes outbound calls to new enrollees and existing members as needed to support accurate and timely enrollment processing requirements
  • Assist Finance with premium revenue and accruals for month end close

Attributes to success:

  • Flexibility and willingness to change as according to business needs
  • Consistently achieve quality and productivity standards
  • Strong financial acumen
  • Attention to detail
  • Enjoys communicating with members

Desired skills and experience:

  • High School graduate required. Associate or Bachelor’s desirable
  • A minimum of 1 year of related experience preferred
  • Strong computer experience - typing, talking, using our system for information entry and all at the same time
  • Knowledge of Medicare Advantage eligibility requirements desired

If you love running towards complex challenges and transforming them into solutions, if you want to make a potentially huge impact on many lives, and if you are looking for a disruptive startup with an inspiring and talented team, Devoted Health may be the place for you!

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Location

Our sunny office is in the beautiful Watch Factory alongside the Charles River in Waltham. It's easily reachable by commuter train, bus, or bike.