Centene Corporation Membership Accounting Representative III (Operations) in Woodland Hills, California

Description:

Position Purpose: Allocates payments, reconciles and audits assigned individual and employer group accounts. Handles escalated and/or complex issues. Collect delinquent dues from employer groups. This position maintains days in Accounts Receivable by managing and monitoring the reconciliation and collection activity, maintains manual cash application turnaround, and maintains allocation accuracy.

  • Allocates, calculates and processes complex and escalated employer group payments; reviews unapplied cash report for guidance.
  • Reconciles received payments received to identify months payment discrepancies. Resolve identified balances (eligibility processing or sending discrepancies to employer group) to maintain client account financial integrity.
  • Collects delinquent dues from employer groups; may monitor, identify, control employer group accounts receivables to collect dues.
  • Researches and resolves problems involving membership exceptions, dues allocation and billing.
  • Frequently monitors account balances to identify issues and allocation processes on assigned accounts.
  • Researches all methods used for reporting eligibility and premium information for discrepancies by utilizing the Business Analyst Teams (Tape Audit, Premium Reconciliation, Charge Level Reconciliation) in managing assigned accounts.
  • Creates and maintains current detailed account documentation on assigned accounts; applies payments and audits to maintain client account financial integrity.
  • Performs audits on individual and employer group accounts.
  • Handles internal and external inquiries concerning billing, rates, and members.
  • Provides guidance and assistance to Eligibility Rep Staff with shared accounts.

Qualifications:

Education/Experience: Bachelor s Degree in Accounting, Business Administration, or a related field preferred. Minimum four years accounting experience within HMO/healthcare industry required.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Job: Health Insurance Operations

Organization: Health Net of California

Location: California-Woodland Hills

Requisition ID: 1063224