Job Description

Job Description
Job Summary
Responsible for preparation, processing and maintenance of new members and re-enrollment. Processes and maintains health plan's member and enrollment records, employer's monthly reports, sending membership cards and materials. Verify enrollment status, make changes to records, research and resolve enrollment system rejections. Address a variety of enrollment questions or concerns received via call tracking, claims, or e-mail. Maintain records in the enrollment database.

Knowledge/Skills/Abilities
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 Molina application to ensure accurate information is represented in Molina's enrollment system.
Assists with the support of the newborn enrollment functions, to include call center requests for verification and updates, PCP assignment activity, enrollment record error reports, enrollment/disenrollment activity and Mass Member Moves.
Work on claims queue to ensure timely and accurate processing of claims pended due to enrollment or COB related issues.
Job Qualifications
Required Education
Associate's Degree or equivalent combination of education and experience
Required Experience
1-3 years working with Medicare or Dual Programs
Preferred Education
Bachelor's Degree or equivalent combination of education and experience
Preferred Experience
3-5 years working with Medicare or Dual Programs

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
About Us

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Job Type: Full Time Posting Date: 04/05/2021