Enrollment Resolution Analyst I

Capital District Physicians Health Plan Inc; City of Binghamton (NY); Hybrid; USD 55,000 - 72,000; Full time

Job summary

Capital District Physicians Health Plan Inc is seeking an Enrollment Resolution Examiner to resolve complex enrollment and billing issues across multiple operational areas. The role involves reconciling enrollment data, updating member records, and preparing performance reports to ensure accurate payments and compliance with state and federal guidelines.

The position requires strong analytical skills, attention to detail, and the ability to work with internal teams and external customers.

Qualifications

• 3 years' experience with financial data or Health Insurance Enrollment experience.
• Ability to prioritize assignments and work independently within established time frames.
• Strong written and verbal communication skills.
• Proficient with MS Office.
• Detail-oriented and analytical.

Responsibilities

• Reconcile regulatory and Health Plan Enrollment data through audit and review to ensure accurate billing and financial records.
• Update member/group documentation to resolve account discrepancies and ensure accurate enrollment data.
• Investigate and monitor operational issues during financial balancing and contribute to process improvements.
• Prepare regular reports on enrollment transactions and processing guidance.

Skills

Financial analysis

Enrollment experience

Relationship building

Prioritization

Flexibility

Communication skills

Organization

MS Office

Attention to detail

Education

Associate degree in finance or accounting

Tools

Microsoft Office Suite

Job description

Capital District Physicians Health Plan Inc is seeking an Enrollment Resolution Examiner to resolve complex enrollment and billing issues across multiple operational areas. The role involves reconciling enrollment data, updating member records, and preparing performance reports to ensure accurate payments and compliance with state and federal guidelines.

The position requires strong analytical skills, attention to detail, and the ability to work with internal teams and external customers.