Sacramento, California, United States
- Gather, analyze and interpret client requirements; recommend administrative solutions to meet the client’s unique requirements for individual billing and enrollment - Install new and renewing clients in VSP’s individual billing system, input rates to generate member bills and track receivables - Ensure accurate and timely posting of all Accounts Receivables - Process enrollments in the Open Enrollment Application and troubleshoot any eligibility or system issues related to the enrollment process - Monitor numerous departmental reports to validate and reconcile client information, member eligibility and revenue applications
- Gather, analyze and interpret client requirements; recommend administrative solutions to meet the client’s unique requirements for individual billing and enrollment - Install new and renewing clients in VSP’s individual billing system, input rates to generate member bills and track receivables - Ensure accurate and timely posting of all Accounts Receivables - Process enrollments in the Open Enrollment Application and troubleshoot any eligibility or system issues related to the enrollment process - Monitor numerous departmental reports to validate and reconcile client information, member eligibility and revenue applications
- Process and adjudicate suspended claims. - Research and resolve specialized claims suspense issues within established guidelines. - Escalate issues for which there is not a documented procedure or precedent - Provide surface level medical review of claims requiring judgment decisions and verification of medical necessity. - Solve routine manual pricing issues within established guidelines - Maintain performance within defined qualitative and quantitative objectives.
- Compose and edit correspondence and documents, such as memoranda, meeting minutes and agendas, emails, documents, mailing preparation and reports. - Performs a variety of administrative and/or secretarial support activities for contract supervisor such as composing replies to correspondence on own initiative, interpreting and explaining established policy and procedure in response to inquiries from a variety of sources, summarizing reports and information to facilitate review by superior and investigating, evaluating and resolving problems within scope of position. - Maintain calendar(s) for assigned individuals, regularly prioritizing and arranging meetings, conferences and appointments, arranges necessary travel reservations itineraries, anticipates and prepares background materials as needed. Assist planner with off-site events and general administrative tasks as needed.
- Process enrollments within company mandated guidelines. - Ensure enrollment applications meet all requirements for proper determination of member eligibility. - Use a personal computer with multiple sub systems to enter enrollment applications and research member enrollment information. - Perform outreach to brokers and prospective members to secure additional enrollment information and or required documentation. - Perform data quality across multiple softwares to ensure member account accuracy.