POSITION SUMMARY
This position is responsible for maintaining the enrollment data for all clients. Focus on the accuracy and integrity of all Medicaid and Medicare specific data as well as client and other regulatory requirements. Additional responsibilities include working with the Director and Manager on key audits and Quality Assurance measures.

REQUIREMENTS FOR ALL POSITIONS
All employees shall meet Compliance/Privacy Regulations and attend at a minimum one (1) hour of Compliance/Privacy educational training annually, as required by Independent Living Systems.
All employees shall meet Risk Management Regulations and attend at the minimum one (1) hour of Risk Management education and training within the first thirty (30) days of employment and as required by law or Independent Living Systems; and, for that non-physician in clinical direct care delivery services, annually thereafter.

POSITION RESPONSIBILITIES AND ACCOUNTABILITY

• Process the enrollment, disenrollment and maintenance of all Medicaid, and Medicare membership for all plans.
• Run programs and conduct membership reconciliation for Medicaid/Medicare products.
• Responsible for the timely completion of all eligibility updates.
• Responsible for the submission of regulatory files to DOH and CMS.
• Responsible for the completion of PCP panel transfers with letters to members as necessary.
• Run and QA ID cards.
• Data enter applications as needed.
• Complete special projects as needed.
• Assist in writing department policies and procedures and workflows for all plans and processes.
• Work closely with management and eligibility staff to ensure all departmental tasks are completed.
• Assist management with implementation of new clients.
• Assist with training of new employees.
• Assist in the quality assurance process.

Assist in the development of quality assurance processes for new clients and new functions.

POSITION QUALIFICATIONS

• Bachelors or Associates degree and/or equivalent work experience required.
• Minimum of two years with Medicaid and/or Medicare eligibility experience.
• Excellent written, verbal and grammatical communication skills required.
• Ability to read, interpret, analyze technical / business procedures and / or governmental regulations required.
• Ability to write reports, business correspondence and procedural manuals required.
• Knowledge of automated systems (technical adeptness) required.
• Demonstrated proficiency in Microsoft programs (ie, Excel, Word, PowerPoint) required; knowledge of Microsoft Access preferred

TRAVEL
This position requires minimal travel.

DRUG FREE WORKPLACE
In compliance with the Drug-Free Workplace Act of 1988, Independent Living Systems and its subsidiaries have a longstanding commitment to provide a safe, quality-oriented and productive work environment. Alcohol and drug abuse pose a threat to the health and safety of ILS employees and members and to the security of the company's equipment and facilities. For these reasons, ILS is committed to the elimination of drug and alcohol use and abuse in the workplace.

EEO STATEMENT
Independent Living Systems, LLC, and its subsidiaries, including FCC, provides equal employment opportunity to all individuals regardless of their race, color, creed, religion, gender, age, sexual orientation, national origin, disability, veteran status, disability, ancestry, or any other characteristic protected by state, federal, or local law. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Job Type: Full-time

Benefits:

• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Ability to commute/relocate:

• Miami, FL 33166: Reliably commute or planning to relocate before starting work (Required)

Experience:

• Microsoft Powerpoint, Microsoft Excel: 1 year (Required)
• Medicaid and/or Medicare eligibility: 2 years (Required)
• governmental regulations required: 2 years (Required)

Work Location: One location

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