Enrollment Specialist

COMPANY OVERVIEW

Zing Health is a tech-enabled insurance company making Medicare Advantage the best it can be for those 65-and-over. Zing Health has a community-based approach that recognizes the importance of the social determinants of health in keeping individuals and communities healthy. Zing Health aims to return the physician and the member to the center of the health care equation. Members receive individualized assistance to make their transition to Zing Health as easy as possible. Zing Health offers members the ability to personalize their plans, access to facilities designed to help them better meet their healthcare needs and a dedicated care team. For more information on Zing Health, visit www.myzinghealth.com.

SUMMARY DESCRIPTION:

Zing Health Plan is looking for an analytical, responsible, and strategic team player like you to join our Enrollment Team! The Enrollment Specialist is responsible for performing duties related to enrollment of Medicare beneficiaries. The Enrollment Specialist is required to make eligibility determinations based on CMS (Part A/Part B Eligibility) in accordance with the application election period guidelines. 

ESSENTIAL FUNCTIONS:

• Ensure the accuracy and timeliness of processing enrollments and disenrollment in compliance within Medicare regulations and Zing policies and procedures
• Demonstrates the skills and ability to analyze information to make appropriate decisions regarding eligibility in compliance with regulations and governance set forth by the Centers for Medicare Services (CMS) and Zing Health Inc.
• Process daily applications and disenrollment received via the various sources in the membership systems for daily transmission to CMS
• Processing new or maintenance updates to enrollment eligibility in the membership systems
• To accurately identify appropriate election period based upon analysis of beneficiary/member history and regulatory guidance
• Assist with daily reviews and processing of the Daily Transaction Reply Report (DTRR)
• Assist with tracking and oversight of CMS OEC, Auto and Facilitated web-based files
• Generate appropriate correspondence to outreach to members request, as necessary
• Performs root cause Description analysis to determine issues related to member inquiry and or system errors
• Must adhere to and keep up to date with new regulations and guidance provided during training updates
• Attention to detail is critical to the success of this position, with skills in customer orientation
• Accurately enter COB for timely and accurate claims adjudication
• Assist mailroom with processing Return Mail
• Adhere to productivity, quality and compliance expectation
  

QUALIFICATIONS AND REQUIREMENTS:

JOB REQUIREMENTS:

• Bachelor’s degree preferred
• Knowledge and thorough understanding of managed care operations
• Ability to work independently, set priorities and meet deadlines
• 1+ years’ experience with Medicare preferred
• Strong knowledge/Proficiency with MS Office