Supervisor, Medicare Advantage Enrollment & Billing

Blue Cross and Blue Shield of Louisiana Inc.; Monroe (LA); On-site; USD 65,000 - 90,000; Full time

Job summary

Blue Cross and Blue Shield of Louisiana Inc. is seeking a Supervisor in Enrollment & Billing to lead a Medicare-focused team. The role drives end-to-end enrollment, eligibility and billing processes, ensuring accuracy and regulatory compliance across units.

Strong leadership and coaching are essential to develop frontline staff and optimize workflow. The position requires CMS knowledge, experience with Facets/EAM and ESI systems, and the ability to coordinate across multiple internal

Qualifications

• Requires High School Diploma or equivalent; Bachelor's degree preferred.
• 3 years of operational experience required; 1 year of leadership demonstrated.
• Experience in Enrollment & Billing; CMS regulations knowledge.
• Must communicate effectively with tact, diplomacy and professionalism.
• Proficiency with MS Word, Excel, Outlook and related software; learn new systems.

Responsibilities

• Administers all HR functions for the team including hiring, performance reviews and workload management.
• Oversees CMS enrollment and eligibility processes, ensuring accuracy and compliance.
• Serves as subject matter expert on end-to-end enrollment/billing processes; trains staff.
• Maintains inventory/tracking dashboards and monitors daily workload and issues.
• Identifies system/process gaps, notifies stakeholders and tests changes.
• Delivers enrollment and billing training and supports process improvements.
• Monitors outsourcing relationships to ensure service levels and quality standards.
• Participates in corporate projects and collaborates with internal departments.

Skills

Leadership

Communication

Coaching

Analytical skills

Organizational skills

CMS knowledge

Enrollment systems

MS Word

MS Excel

MS Outlook

Education

High School Diploma

Bachelor's degree

Tools

Facets/EAM

ESI

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 PURPOSEThe 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 SCOPEManages PeopleThis role directly manages these jobs: Medicare Enrollment Specialist, Medicare Enrollment Specialist II, Senior Medicare Enrollment SpecialistThis role reports to departmental leadershipNecessary 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.QUALIFICATIONSEducationHigh School Diploma or equivalent is requiredBachelor's is preferredWork Experience3 years of operational experience is required1 year of demonstrated leadership is requiredExperience can run concurrentlyEnrollment & Billing experience is preferredA Supervisor, Enrollment & Billing who works on the Medicare LOB must have knowledge of CMS regulations, Medicare enrollment requirements, and reporting processes, as well as experience using enrollment, billing, and reporting systems such as Facets/EAM, ESI, and other Medicare-related platforms.Skills and AbilitiesMust demonstrate verbal and communication skills with the ability to interpret and communicate information with tact, diplomacy, patience and professionalism.Must have strong organizational and analytical abilities and effective interpersonal skills. Must be able to recognize inconsistencies and gaps in business processes and take appropriate actions.Must be able to prioritize multiple responsibilities, make decisions, find solutions and work independently in order to meet aggressive deadlines, and adapt to a fast-paced, changing environment.Must be able to coach and develop front line staff.Able to cohesively work in team environment to ensure efficient and effective completion of all tasks for assigned groups.Must have working knowledge of relevant software (e.g., MS Word, Excel, Outlook, etc.) and related software as well as other corporate programs and applications and the ability to learn new systems.The applicant selected must complete the recommend BCBSLA Leadership Development Program within 6 months of start date in the supervisor position.Must have thorough insurance knowledge to apply company policies and procedures, company guidelines, state and federal laws and mandates to ensure information is current and accurate.Licenses and CertificationsNone RequiredACCOUNTABILITIES AND ESSENTIAL FUNCTIONSAdministers 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 FunctionsThe 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 functionsPerform 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 EmployerAll internal employees please apply through Workday Careers.PLEASE USE A WEB BROWSER OTHER THAN INTERNET EXPLORER IF YOU ENCOUNTER ISSUES (CHROME, FIREFOX, SAFARI)Additional InformationPlease 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.