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Job Details

Enrollment & Billing Team Lead

Requisition #: 413683
Location: Johns Hopkins Health Care, Hanover, MD 21076
Category: Non-Clinical Professional
Work Shift: Day Shift
Work Week: Full Time
Weekend Work Required: No
Date Posted: Sept. 16, 2021

Johns Hopkins HealthCare (JHHC) is the managed care and health services business of Johns Hopkins Medicine, one of the premier health delivery, academic, and research institutions in the United States. JHHC is a $2.5B business serving over 400,000 lives with lines of business in Medicaid, Medicare, commercial, military health, health solutions, and venture investments. JHHC has become a leader in provider-sponsored health plans and is poised for future growth.

Many organizations talk about transforming the future of healthcare, Johns Hopkins HealthCare is actually doing it. We develop innovative, analytics-driven health programs in collaboration with provider partners to drive improved quality and better health outcomes for the members and communities we serve. If you are interested in improving how healthcare is delivered, join the JHHC team.

Position Summary:

Under limited direction, the Enrollment and Billing Team Lead will be responsible for resolving enrollment discrepancies and performing complex and escalated enrollment and billing tasks. This position is essential to ensuring all eligible beneficiaries are properly enrolled in their respective plan(s), preventing future issues with members using services covered by their plan, as well as ensuring member premiums are properly assessed and billed. The Enrollment and Billing Team Lead will be responsible for all functions related to membership, including but not limited to: updates to the data, verification of eligibility, the issuance of ID cards, membership and group reconciliations; ensuring all duties are performed in accordance with Center for Medicare & Medicaid (CMS), Department of Defense (DOD), and NCQA guidelines. Additionally, the Enrollment and Billing Team Lead will possess a strong knowledge of all product lines that are administered by JHHC.

This individual must possess and demonstrate excellent verbal and written communication skills in order to interact with all levels of customers both internal and external. Additionally, this individual must have an understanding of the health care environment and sensitivity to confidential information and adherence to HIPAA regulations. The Enrollment and Billing Team Lead will also be responsible for the creation, distribution and/or upkeep of various Enrollment and Billing reports.

Responsibilities of an Enrollment and Billing Team Lead will include:

  • Researching, processing, and finding solutions for routine and complex enrollment issues
  • Searching records, analyzing data to determine the next steps for discrepancy resolution and making updates as necessary
  • Effectively understanding and navigating multiple enrollment systems/databases simultaneously
  • Adhering to strict mandated turn-around times and ensuring that team members achieve SLAs and goals
  • Communicating professionally with members, internal departments and other team members
  • Collecting member premiums, updating the appropriate payment system(s), issuing invoices as well as researching and resolving payment/billing discrepancies
  • Serving as a subject matter expert to peers and others; will be the primary point of contact for escalations from internal and external contacts
  • Precepting/training of new hires
  • Creating, generating, updating and/or distributing reports
  • Conducting testing and recommending changes to processes to promote efficiency within the department
  • Recommending changes to processes to promote efficiency within the department

Education

High School diploma or equivalent required

Associates Degree in Healthcare Administration or Business preferred

Knowledge

Strong knowledge of healthcare insurance principles

Must possess strong knowledge of reporting functions as well as Microsoft Office; including Word, Access, and Excel, and the ability to create and maintain reports

Must possess the ability to maintain strong relationships with team members including the ability to precept/train newly hired team members

Knowledge of Healthcare Database Systems MC400, MSR, DEERS, Epic and Healthsuite

Must have demonstrated ability to handle special tasks as designated by management

Skills

Excellent interpersonal and listening skills

Well-developed telephone and customer service skills

Demonstrated written and verbal communication skills necessary to interact with a diverse patient population, providers and staff

Ability to handle sensitive and confidential information

Strong administrative skills

Strong problem solving skills

Ability to organize, prioritize and manage to manage multiple tasks

Highly developed sense of integrity and commitment to providing an excellent member experience

Ability to maintain strong relationships with team members including the ability to precept newly hired team members

Required Licensure, Certification, Etc.:

Induvidual must be able to obtain and maintain a CAC card which requires the successful completion/passing of a DOD administered background check.

Work Experience

Requires 2-3 years managed care, health insurance, medical office or related experience in an office setting, preferably in an enrollment and/or billing role

Machines, Tools, Equipment

Must be able to operate general office and phone equipment

Johns Hopkins Health System and its affiliates are Equal Opportunity/Affirmative Action employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sexual orientation, gender identity, sex, age, national origin, disability, protected veteran status, and or any other status protected by federal, state, or local law.

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