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IEHP Eligibility Reconciliation Analyst

Inland Empire Health Plan

Rancho Cucamonga, CA
1 month ago

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This job listing is no longer available for applications. The position may have been filled or the posting period has ended.

Job Description

*Job Summary*
Under the Manager, Business Systems Operations Support, the Eligibility Reconciliation Analyst will identify, research & resolve discrepancies between source data and IEHP eligibility data. The incumbent is responsible for identifying and resolving discrepancies in Member's demographic, enrollment, premium and eligibility data between federal and/or state data against IEHP's membership. The Reconciliation Analyst will perform a variety of duties related to membership reconciliation from various sources.

*Education & Requirements *
* At least two (2) years of relevant experience: a minimum of one (1) year of experience demonstrating excellent organizational, time management, and facilitation skills required
* Experience demonstrating initiative and self-direction with the ability to work well independently and in teams while serving as a Subject Matter Expert (SME) required
* Also includes at least one year of eligibility research experience in a managed care setting required
* Minimum of 1 year experience and knowledge of Covered California regulatory requirements and membership reconciliation preferred
* Minimum of 1 year experience and knowledge of Medicare regulatory requirements preferred
* Experience with Covered CA or other Exchange products preferred
* Bachelor’s Degree in Business Administration, Health Care Administration, Computer Information Systems (CIS), Management Information Systems (MIS), or other related field from an accredited institution required
* One (1) of the following scenarios will be accepted in lieu of a Bachelor’s degree:
* In lieu of the required degree, a minimum of four (4) years of additional relevant work experience is required for this position: Two (2) years of Health Care or Managed Care Operations experience and a minimum of two (2) years of data reconciliation or experience working with Eligibility data is required
* This experience is in addition to the minimum years listed in the Experience Requirements above

*Key Qualifications*
* Experience and/or knowledge of the 834-file format system preferred
* Requires excellent critical thinking, root cause analysis, and problem-solving skills as well as excellent written and verbal communication skills with the ability to communicate and present effectively in large forums to discuss complex information
* Also requires a high level of attention to detail
* Ability to work independently and solve complex problems with little to no assistance
* Effectively manage multiple competing priorities and adhere to strict timelines
* Ability to effectively manage multiple competing priorities
* Ability to manage multiple projects of varying complexity, priority levels and deadlines

Job Type: Full-time

Pay: $63,897.60 - $83,075.20 per year

Benefits:
* 401(k)
* Dental insurance
* Flexible spending account
* Health insurance
* Paid time off
* Tuition reimbursement
* Vision insurance
Schedule:
* Day shift
* Monday to Friday

Work Location: Hybrid remote in Rancho Cucamonga, CA 91730