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Membership Finance Coordinator

2 weeks ago

Cebu City, Central Visayas, Philippines beBeeAccounting Full time ₱500,000 - ₱800,000
Accounting Professional Opportunity

We are seeking an experienced Accounting Professional to join our team. As a key member of our organization, you will be responsible for resolving discrepancies in Enrollment, Billing and/or Reconciliation processes in a timely and accurate manner.

The ideal candidate will have excellent analytical and problem-solving skills, with the ability to work independently and as part of a team. They will possess strong communication and interpersonal skills, with the ability to interact effectively with colleagues, management, and customers.

Key Responsibilities:

  • Process queue items, customer requests and inter-departmental correspondence timely and accurately.
  • Review incomplete and pending enrollment applications and disenrollment forms for correction and submission.
  • Complete Late Enrollment Penalty (LEP) Attestations and Other Health Insurance (OHI) verification.
  • Create retro processing packets for submission to CMS Retro Processing Contractor (RPC).

Billing and Reconciliation Functions:

  • Identify and post customer payments not automatically applied by the system.
  • Respond to billing-related correspondence and investigate returned checks and rejected transactions.
  • Process premium payment requests via credit card or ACH withdrawal and approve/deny customer refunds.

Additional Requirements:

  • Working knowledge of Centers for Medicare & Medicaid Services (CMS) guidance and regulations.
  • Ability to perform outbound calls to customers and other entities as permitted.
  • Prepare reports as requested by management and perform other duties as required.

Requirements and Qualifications:

  • High school diploma required; Associates Degree or higher preferred.
  • Minimum 2 years experience in Health Plan Operations including Customer Service, Enrollment, and Claims processing.
  • Excellent analytical, decision-making, problem-solving, team and time management skills.