Enrollment Analytics Specialist (Remote)

Molina Healthcare; Chicago (IL); On-site; USD 25,000 - 54,000; Full time

Job summary

Molina Healthcare is seeking an Enrollment Analyst to support member enrollment activities, maintain records, and provide customer service to members, providers, and employer groups. The role involves handling enrollment exceptions, preparing reports, and coordinating with state agencies across multiple states.

Responsibilities include tracking exceptions, researching discrepancies in state payments, forecasting enrollment trends, and assisting with SOX audit data submissions while ensuring

Qualifications

• At least 2 years of experience in health care, and/or customer/provider services experience, or equivalent combination of relevant education and experience.
• Proficiency in data analysis tools and techniques.
• Customer service experience.
• Data processing and proofing experience.
• Attention to detail, organizational and time-management skills, and ability to manage simultaneous projects and tasks to meet internal deadlines.
• Ability to maintain confidentiality and comply with HIPAA.
• Ability to establish and maintain positive and effective work relationships with coworkers, members, providers and customers.
• Effective verbal and written communication skills.
• Microsoft Office suite and applicable software programs proficiency.

Responsibilities

• Facilitates the daily process of member exceptions from state eligibility files and takes appropriate action to ensure members are properly enrolled.
• Tracks and follows-up on any exceptions with revenue amounts expected from state(s) and maximizes recovery.
• Researches discrepancies from state payments in order to ensure accurate payment to health plan(s).
• Compiles and reviews all reports and historical trends, and forecasts future enrollment activities.
• Prepares daily performance reports, summarizing KPIs related to enrollment statistics.
• Facilitates and coordinates meeting materials with health plan compliance departments and operations leadership for multiple states.
• Demonstrates subject matter expertise in enrollment processes for multiple states.
• Assists with projects as assigned by leadership related to trend analysis, inventory, or other enrollment-related areas.
• Facilitates quality reviews and submission of deliverables to the government contracts team and state Medicaid agencies.
• Tracks all contractual-related enrollment tasks to completion.
• Monitors inventory analysis provided by third party vendors for accuracy and explanation.
• Records and publishes enrollment events on SharePoint that are available for department and third-party vendor use.
• Assists leadership with preparation of submission of Sarbanes-Oxley (SOX) audit data to internal and external auditors.
• Assists with complex enrollment issues concerning member eligibility.

Skills

Data analysis

Customer service

Data processing

Attention to detail

Verbal and written communication

HIPAA compliance knowledge

Tools

Microsoft Office

Job description

Molina Healthcare is seeking an Enrollment Analyst to support member enrollment activities, maintain records, and provide customer service to members, providers, and employer groups. The role involves handling enrollment exceptions, preparing reports, and coordinating with state agencies across multiple states.

Responsibilities include tracking exceptions, researching discrepancies in state payments, forecasting enrollment trends, and assisting with SOX audit data submissions while ensuring