.Helpware is a technology-driven company with offices in the USA, Ukraine, Mexico, and the Philippines which provides Customer Experience & Operational Support for modern companies. Our team of professionals is driven by the purpose of providing best-in-class value-adding services to our partners by leveraging our empowered teams, innovative solutions, and technologies.Position Summary:The Membership Accounting Analyst is responsible for the timely and accurate resolution of discrepancies identified in the Enrollment, Billing and/or Reconciliation processes. The analyst will review documentation, work items in queues and correct errors, identify trends and document resolutions.Responsibilities:Enrollment ProcessingProcess queue items, inter-departmental and customer requests timely and accuratelyReview incomplete and pending enrollment applications and disenrollment forms for correction and submission to Centers for Medicare & Medicaid Services (CMS)Review and complete Late Enrollment Penalty (LEP) AttestationsReview and complete Other Health Insurance (OHI) verification and error correctionReview and create retro processing packets to be submitted to the CMS Retro Processing Contractor (RPC)Billing ProcessingIdentify and post customer payments not automatically applied by the appropriate systemRespond to billing-related correspondenceReview and investigate returned checks, rejected ACH and credit card transactionsProcess requests for automated premium payment via credit card or ACH withdrawalReview and approve/deny customer requests for premium refunds in accordance with established policiesMonthly State Pharmaceutical Assistance Programs reconciliationReconciliation ProcessingResearching and correcting errors, discrepancies, and rejected transactions.Monthly review and preparation of the CMS Enrollment Data Validation file and submissions.All Functions:Working understanding of Centers for Medicare & Medicaid Services (CMS) guidanceConform with and abide by all regulations, policies, work procedures and instructionsMeet CMS guidelines and client Service Level Agreement (SLA) requirements through the proper handling of transactionsPerform outbound calls to customers or other entities as permitted to complete processing of enrollment, disenrollment, billing and or reconciliation transactionsMake appropriate system corrections and escalate transactions that are unable to be correctedPrepare reports as requested by managementPerform other duties and responsibilities as requiredRequirements:High school diploma required; Associates Degree or higher preferred
