Membership Billing & Reconciliation Analyst (CMS)

Doist; Cebu City; On-site; PHP 334,800 - 580,320; Full time

Job summary

Doist in Cebu City is seeking a Membership Accounting Analyst to resolve discrepancies in Enrollment, Billing and Reconciliation processes. The role reviews documentation, processes queues and corrects errors while identifying trends.

You will handle CMS-related requirements, HIPAA compliance, and communications with customers. Requires high school diploma and 2 years in health plan operations; associates preferred.

Qualifications

• High school diploma required; Associates Degree or higher preferred.
• Minimum 2 years Health Plan Operations experience including; Customer Service, Enrollment, and/or Claims processing.
• Excellent analytical, decision-making, problem-solving, team, and time management skills.
• Excellent oral and written communication skills.
• HIPAA regulations awareness and compliance.
• Data entry and typing skills.
• Ability to handle stressful situations with empathy.
• Strong interpersonal and collaboration skills.

Responsibilities

• Process enrollment, billing, and reconciliation queue items accurately and promptly.
• Review incomplete enrollment applications and corrections for CMS submission.
• Review LEP attestations and OHI verification; correct errors as needed.
• Prepare retro processing packets for CMS RPC Billing Processing.
• Identify and post customer payments not automatically applied.
• Respond to billing-related correspondence and customer inquiries.
• Investigate returned checks, rejected ACH and credit card transactions.
• Handle automated premium payment requests by credit card or ACH.
• Process premium refunds per policy and SLA.
• CMS Enrollment Data Validation file preparation and submissions.

Skills

Analytical skills

Communication

Problem solving

Teamwork

Data entry

Typing

HIPAA knowledge

Customer service

Time management

Interpersonal skills

Education

High school diploma

Associate degree or higher preferred

Tools

CMS

Job description

Doist in Cebu City is seeking a Membership Accounting Analyst to resolve discrepancies in Enrollment, Billing and Reconciliation processes. The role reviews documentation, processes queues and corrects errors while identifying trends.

You will handle CMS-related requirements, HIPAA compliance, and communications with customers. Requires high school diploma and 2 years in health plan operations; associates preferred.