Medicaid Enrollment Specialist
Senior Process Associate
In the role of senior process associate, you will execute transactions as per prescribed guidelines and timelines, reviews and validates the inputs from the other team members, support your manager in training activities, daily operations reviews and help in escalation resolution with the objective to meet service level agreement targets for the specific process within the guidelines, policies and norms of Infosys.
Responsibilities may include but are not limited to:
- Performs processes to resolve the following eligibility exceptions within the required State/Regulatory timeframes:
enrollment file errors, ID card generation errors, PCP assignments and 834 enrollment files to vendor/third party administrators. - Process COB eligibility through proper application to ensure accurate information is represented in company enrollment system
- Assists with the support of the newborn enrollment functions, to include call center, claims, and encounter requests for verification and updates, PCP assignment activity, enrollment record error reports, enrollment/disenrollment activity and Mass Member Moves.
- As needed is available to support special projects
- Assist to maintain integrity of eligibility tasks.
- External phone call with other health insurances to determine primary payer.
- Prioritizes daily, weekly and monthly job tasks to support regulatory requirements and service level agreements.
- Displays imitative to complete assigned tasks timely and accurately and balances workload to assist peers and Supervisor.
- Provides knowledgeable response to internal and external inquiries regarding eligibility, ID cards, selection of primary, care provider, and state enrollment transactions.
- Reconciles eligibility with State Agencies using varied methods. Tracks and documents all transactions with State Agencies.
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Qualifications
Basic
- High School Diploma or GED Equivalent
- At least 1 year of related work experience
- Excellent interpersonal and communication skills to deal effectively with all necessary levels within and outside the organization.
- Demonstrates analytical and innovative excellence for current state and future state challenges at both the strategic and tactical level.
- Strong organizational skills and superior attention to detail. Strong decision maker.
- Ability to review documents for accuracy, completeness, and compliance; compile data and information for reports; compose letters and memoranda.
- Ability to gather and research data (i.e., statutes, regulations, articles).
The job entails sitting as well as working at a computer for extended periods of time. Should be able to communicate by telephone, email, or face to face.
About Us
Infosys BPM Limited, a wholly owned subsidiary of Infosys Limited (NYSE: INFY), provides end-to-end transformative business process management (BPM) services for its clients across the globe. The company's integrated IT and BPM solutions approach enables it to unlock business value across industries and service lines, and address business challenges for its clients. Utilizing innovative business excellence frameworks, ongoing productivity improvements, process reengineering , automation , and cutting-edge technology platforms, Infosys BPM enables its clients to achieve their cost reduction objectives, improve process efficiencies, enhance effectiveness, and deliver superior customer experience.
Infosys BPM has 43 delivery centers in 16 countries spread across 5 continents, with 58,745 employees from 124 nationalities, as of March, 2023.
The company has been consistently ranked among the leading BPM companies globally and has received over 60 awards and recognitions in the last 5 years, from key industry bodies and associations like the Outsourcing Center, SSON, and GSA, among others. Infosys BPM also has very robust people practices, as substantiated by the various HR-specific awards it has won over the years. The company has consistently been ranked among the top employers of choice, on the basis of its industry leading HR best practices. The company's senior leaders contribute widely to industry forums as BPM strategists.