Supervisor, Medicare Advantage Enrollment & Billing

Louisiana Blue; Monroe (LA); On-site; USD 60,000 - 95,000; Full time

Job summary

BCBSLA in Louisiana is seeking a Supervisor, Enrollment & Billing to lead the Medicare enrollment team, organize workflows, and coach staff to ensure productive operations and compliance with CMS standards. The role requires guiding and training employees and managing end-to-end processes.

The position involves coordinating with many internal departments and external partners, monitoring performance, and driving improvements while maintaining data accuracy and service quality.

Qualifications

• Experience managing enrollment and billing teams and workflows.
• Ability to follow CMS standards for enrollment and eligibility.
• Knowledge of HIPAA and regulatory compliance requirements.
• Strong coordination with internal and external stakeholders.
• Excellent organizational and coaching abilities.

Responsibilities

• Administers HR functions: hiring, performance reviews, schedules, workload and staff development.
• Oversees enrollment and eligibility processes in Medicare line of business.
• Acts as subject matter expert on end-to-end processes and regulatory changes.
• Logs inventories and monitors inventory tracking dashboards.
• Identifies system gaps, communicates issues, and tests changes.
• Provides dedicated customer service and maintains cross-functional relationships.
• Monitors daily tasks and facilitates projects and vendor relationships.

Skills

People management

Coaching

Staff training

Performance reviews

Workload management

Tools

CMS standards

Enrollment systems

HIPAA compliance

Job description

We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities. We invite you to apply for a career with us.

Residency in or relocation to Louisiana is preferred for all positions.

POSITION PURPOSE

The Supervisor in the Enrollment and Billing department is responsible for the end to end process for their assigned team including organizing workflow, ensuring that employees understand their duties or delegated tasks, monitoring employee productivity and providing constructive feedback and coaching. The ideal candidate will be able to manage, guide and train employees. The Supervisor will be well-versed in processes under the role’s responsibility and will be result-driven and focused, with the goal to ensure that operations are carried out productivity to ensure profitability and sustainable growth. Oversees compliance mandates coming from federal and state regulatory agencies.

NATURE AND SCOPE

• Manages People
• This role directly manages these jobs: Medicare Enrollment Specialist, Medicare Enrollment Specialist II, Senior Medicare Enrollment Specialist
• This role reports to departmental leadership
  
  

Necessary Contacts: In order to effectively fulfill this position, the incumbent must be in contact with:

Various internal departments including but not limited to: Account Managers/Executives, Accounting, Actuarial, BET, Claims Units, Claims Systems Development Specialists, Corporate Compliance, Customer Services, Executive Management, Installation Managers, IT, Legal, Marketing (including Regional Directors), Plan Performance, Provider and Benefits Specialists, Provider Contracts, Provider Reimbursement System Audit Specialists, Quality Management, Underwriting, and other Enrollment and Billing units and other departments within BCBSLA as needed.

Various External Departments Including But Not Limited To

Agents, Area Offices, Broker, Department of Insurance, Department of Health and Human Resources, Department of Health and Hospitals, Group Leaders, Other plans, outside consultant, vendors and subscribers as needed.

Licenses and Certifications

None Required

Accountabilities And Essential Functions

• Administers all HR functions, including but not limited to, hiring, terminating, conducting performance reviews, setting performance standards, approving work schedules, assigning and directing workload, training and developing staff, coaching, etc. to ensure team goals are met.
• Supervisor, Enrollment & Billing who works on the Medicare line of business (LOB) must be able to follow CMS (Centers for Medicare & Medicaid Services) standards, including overseeing enrollment and eligibility processes, ensuring data accuracy and compliance, resolving enrollment discrepancies, and supporting system and operational improvements.
• Serves as the subject matter expert of end to end process. Maintains thoroughly knowledge of required lines of business, changes to recent state and federal laws and regulations, mandates, HIPPA, and company policies and procedures in order to lead and provide on-the-job training to the unit.
• Logs in the daily inventories to inventory tracking dashboard to monitor daily inventory and ensure management has knowledge about inventory level.
• Identifies system and process functionality gaps that hinder daily performance, responds, and notifies applicable personnel of system problems or equipment failures, tests and approves programming changes to ensure accurate and timely handling of issues.
• Provides dedicated customer service to assigned area. Establishes and maintains strong working relationship with key departments. Facilitates enrollment and billing training as needed or requested.
• Monitors, tracks, and assigns team tasks daily.
• Participates in corporate and other projects as assigned by management. Attends or facilitates meetings as needed. Monitors outsourcing relationships with vendors if necessary, to ensure quality standards and service level agreements are being met.
  
  

Additional Accountabilities And Essential Functions

The Physical Demands described here are representative of those that must be met by an employee to successfully perform the Accountabilities and Essential Functions of the job. Reasonable accommodations may be made to enable an individual with disabilities to perform the essential functions

• Perform other job-related duties as assigned, within your scope of responsibilities.
• Job duties are performed in a normal and clean office environment with normal noise levels.
• Work is predominately done while standing or sitting.
• The ability to comprehend, document, calculate, visualize, and analyze are required.
  
  

An Equal Opportunity Employer

All internal employees please apply through Workday Careers.

PLEASE USE A WEB BROWSER OTHER THAN INTERNET EXPLORER IF YOU ENCOUNTER ISSUES (CHROME, FIREFOX, SAFARI)

Additional Information

Please be sure to monitor your email frequently for communications you may receive during the recruiting process. Due to the high volume of applications we receive, only those most qualified will be contacted. To monitor the status of your application, please visit the "My Applications" section in the Candidate Home section of your Workday account.

If you are an individual with a disability and require a reasonable accommodation to complete an application, please contact [e-mail] for assistance.

In support of our mission to improve the health and lives of Louisianians, we encourage the good health of its employees and visitors. We want to ensure that our employees have a work environment that will optimize personal health and well-being. Due to the acknowledged hazards from exposure to environmental tobacco smoke, and in order to promote good health, our company properties are smoke and tobacco free.

We perform background and pre-employment drug screening after an offer has been extended and prior to hire for all positions. As part of this process records may be verified and information checked with agencies including but not limited to the Social Security Administration, criminal courts, federal, state, and county repositories of criminal records, Department of Motor Vehicles and credit bureaus. Pursuant with sec 1033 of the Violent Crime Control and Law Enforcement Act of 1994, individuals who have been convicted of a felony crime involving dishonesty or breach of trust are prohibited from working in the insurance industry unless they obtain written consent from their state insurance commissioner.

Additionally, we are a Drug Free Workplace. A pre-employment drug screen will be required and any offer is contingent upon satisfactory drug testing results.

JOB CATEGORY: Insurance