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Membership Representative I-Temporary-Managed Care

Job Description

Summary: Coordinates with transmission and receipt of Plan data to & from CMS/DHS. Maintaining compliance and adherence with regulatory requirements. Essential Functions: • Review Medicare Part D to ensure completeness, issue appropriate request transactions when required and make additional contact, which will include issuance of the appropriate CMS approved correspondence. • Track potential applicant contacts to ensure compliance with CMS regulations. • Assist Supervisor/Manager in billing and reconciliation to ensure compliance with Medicare regulations. • Assist in the development and testing of external vendor systems to ensure CMS processing guidelines are met within the designated time frames. • Direct Medicare Part D premium invoicing to include premium bill issuance, payment allocation and reconciliation with Accounting and Finance Dept. • Generate monthly reporting of enrollment related statistics and various database reports • Handle special projects as assigned by management. Knowledge/Skills/Abilities: • Excellent verbal and written communication skills • Ability to abide by Molina’s policies • Maintain regular attendance based on agreed-upon schedule • Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA) •

Job Requirements

-Call center experience 
-Customer service experience 
-Medicare/Medicaid experience 
-Open to changing environment 
-Multitask in a fast paced environment 


Abe Ghebrehiwet
Senior Account Executive
Nurse Resolutions
888.411.2228. X 204 Toll Free
407.982.7508. Fax
[Click Here to Email Your Resumé]

Job Snapshot

Contact Name Abe Ghebrehiwet
Contact Phone 888-411-2228 X204
Post Date 7/15/2014
Location Bothell, WA
Employment Type Full-Time
Job Type Health Care, Nurse, Insurance
Education 4 Year Degree
Experience At least 2 year(s)
Manages Others No
Industry Healthcare - Health Services, Managed Care, Insurance
Required Travel Not Specified
Job ID abe
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