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  • Albuquerque, NM 87102

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Membership Representative

Kforce Finance and Accounting • Albuquerque, NM

Posted 21 days ago

Job Snapshot

Contractor
$10.00 - $13.00 /Hour
Competitive
Insurance
Admin - Clerical
2

Applicants

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Job Description

RESPONSIBILITIES:

Kforce has a client that is seeking a Membership Representative in Albuquerque, NM. The reason for the opening is Open Enrollment. The candidate will be speaking with customers regarding their enrollment plans and applications.

Essential Functions and Responsibilities:
  • Coordinates with transmission and receipt of Plan data to and from CMS/DHS

  • Maintaining compliance and adherence with regulatory requirements

  • 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 Department

  • Generate monthly reporting of enrollment related statistics and various database reports

  • Handle special projects as assigned by management

  • Maintain regular attendance based on agreed-upon schedule

  • Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA)

Job Requirements

REQUIREMENTS:

  • High School diploma required

  • 0-2 years of experience in Medicare Part D.

  • Proficient in Microsoft Soft Office applications and Medicare systems (preferably)

  • Some knowledge and understanding on claims processing and Medicare enrollment applications

  • Multi-task, strong planning skills needed along with ability to set priorities in order to meet deadlines

  • Excellent verbal and written communication skills

  • Bilingual: Spanish

  • Ability to abide by clients's policies

  • Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers, and customers



Kforce is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, pregnancy, sexual orientation, gender identity, national origin, age, protected veteran status, or disability status.

Job ID: OTONS1657759
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