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|Supervisor Membership Accounting--Medicare|
- Job Title
- Supervisor Membership Accounting--Medicare
- Open until filled
- Portland, OR 97204
- Other Location
Let’s do great things, together
Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we’re focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together.
We are seeking a Supervisor for Membership Accounting department, specialize in Medicare. The position will manage the day-to-day operational activities of the Moda and BHS Membership Accounting Department covering a wide range of responsibilities to ensure retention of existing groups, members, regulators and partners and improve efficiency of all administrative services. Core management responsibilities include: Coaching, Supervision, Development, Motivation, Direction and Support to Membership Accounting Specialists. Measures and evaluates results to determine if standards are being met.
1. Responsible for daily operation of billing, eligibility and reconciliation functions in one of; Medicare, Medicaid, Commercial Group, Individual, or BHS.
2. Supervises and develops staff, develops goals, provides daily work direction, vacation scheduling, monitoring work and attendance, and hiring and terminating employees.
3. Ensures that appropriate personnel policies and procedures are followed using coaching, counseling, performance evaluations, promotions, and demotions, as needed.
4. Oversees training of new and existing staff on all billing and eligibility functions, on all product lines, and ensures that staff have the necessary tools and resources to be successful.
5. Assists staff with resolution of problem accounts involving eligibility, billing, and reconciliation.
6. Maintain an understanding on administering eligibility, billing and reconciliation procedures and guidelines as they pertain to your product line(s); Medicare, Medicaid, ACA (Exchange), Employer Group, Retiree Administration, COBRA, etc.
7. Assist in development and implementation of new systems and technology.
8. Resolve complex problems and issues involving other departments, customers, state and federal regulators, agents/brokers and constituents.
9. Be an active, integral, dynamic and contributing member of the Membership Accounting Leadership Team. There will be times when you and your team will help out other Membership Accounting Teams.
10. Ensure excellent customer relations with internal customers, external customers, state and federal regulators, and agents/brokers.
11. Remain aware of developments in your line of business (Medicare, Medicaid, ACA, Employer Group, BHS, etc.) and assist with coordinating plan changes, open enrollment and renewals.
12. Responsible for and always promoting quality and continuous improvement within your department and within the Membership Accounting division.
13. Keep Membership Accounting Manager and/or Director abreast of department activities and concerns.
14. Ensure department quality assurance standards and turn-around times are adhered to through monitoring. Develops effective ways to measure turnaround time and monitor results.
15. Analyzes staffing needs and makes recommendations to Membership Accounting Manager and Director as workload and efficiencies fluctuate.
16. Develops and approves all department Policies and Procedures (UPM’s), works with Membership Accounting Leadership Team on division level Policies and Procedures.
17. Participate in and manage projects as assigned.
18. Responsible for quality and process improvement.
19. Other duties as assigned.
Are you ready to be a betterist?
If you’re ready to make a difference that matters, we want to hear from you. Because it’s time to discover what’s possible.
Together, we can be more. We can be better.
Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law.
- Required Skills
1. College degree or four years relevant industry experience preferred
2. Knowledge of either; COBRA, Retirement plans, Medicare, Medicaid, Commercial Group, Individual, Affordable Care Act, Private Exchanges, or TPA business.
3. 4 years’ experience with Membership Accounting (enrollment, billing, reconciliation) preferred
4. Strong analytical, problem solving, decision-making, and organizational skills.
5. Ability to deal effectively with a variety of individuals, government organizations, agents and groups related to the provision of services designed to retain existing accounts and obtain new accounts.
6. Ability to communicate effectively, both verbally and in writing. Ability to conduct meetings and presentations with internal as well as external customers and constituents.
7. Ability to achieve extraordinary results through effective management of resources, systems and processes.
8. Demonstrate strong, effective and diplomatic interpersonal communication skills with employees of all levels.
9. Ability to work well under pressure, work with frequent interruptions and shifting priorities
10. Ability to hire, lead, motivate, and develop staff.
11. Ability to adapt to change, work independently and as part of a successful team.
12. Maintain attendance above company standards.
13. Ability to maintain confidentiality and project a professional business image.
14. Computer proficiency with Microsoft Office applications.