Job Description

Montage Health’s application process has changed effective 12/20/2019.
If you submitted an online application prior to 12/20/2019, you will be required to recreate your profile information if you want to apply to any new positions. You will no longer have access to your previously saved profiles and applications. Current employees applying for transfer into a posted position must also create a profile.

  • Excellent Pay and Generous Benefits including a Pension and Continuing Education Reimbursement
  • Excellent Team Orientated Culture
  • Free Gym for Employees

Job Description:

Purpose of Position

The Client Services Data Manager will be responsible for direct oversight and production of client eligibility and data reporting for Coastal TPA’s clients as well as Coastal and Aspire Health’s internal data and reporting needs.

Responsibilities

  • Oversee the importing / exporting of 834 and 837 files; acknowledgement files
  • Oversee the processing of  eligibility additions, changes, and terminations as received by Clients and/or vendors
  • Manage the eligibility implementation of new groups, plan changes and client renewals
  • Provide clients, vendors, brokers and other representatives with eligibility and claims reporting, as specified by Client contracts
  • Process acknowledgement files received in response to electronic file feed submissions
  • Develop strong relationships with clients and their vendors for maintenance of effective client and vendor relationships
  • Oversee user access for various systems used by Coastal to include internal and external access
  • Assist in the implementation of electronic file feeds and data extracts
  • Initiate, create and review monthly claims and eligibility reports for upload to Client portal, as required by Client contracts
  • Develop queries based on client, broker, and/or vendor specific report requests
  • Submit applicable data to regulatory agencies, as delegated by Client(s), to include CMS Section 111 Mandatory Reporting
  • Manage Client reinsurance policies and handle all claim filings eligible for reimbursement
  • Responsible for preparation and distribution of internal production reports to management
  • Manage and update department policies and procedures
  • Perform other activities and duties as assigned

Position Requirements

  • Intermediate MS Office skills including Word, Excel, Outlook and PowerPoint required
  • Excellent written and verbal communication skills required
  • Exceptional Alphanumeric Data Entry skills required
  • Knowledge of healthcare contracting, benefit and premium administration
  • Excellent organizational and interpersonal skills
  • Excellent business acumen and writing skills
  • Exceptional diplomacy skills to effectively resolve issues under sometimes tense and stressful circumstances
  • Readily adaptable to the changing needs of the business; able to manage multiple priorities; tolerance for ambiguity
  • Ability to use sound judgement, identify next steps to be taken, and develop appropriate solutions.
  • Ability to collaborate with multiple parties to solve problems
  • SQL and/or ISAM database experience a plus

Competencies

  • Accountability and Dependability: Assumes responsibility for accomplishing duties in an effective and timely manner.
  • Integrity:  Consistently honors commitments and takes responsibility for actions and words. 
  • Software and Computer Skills: Proficient in the use of Microsoft Office Suite, Highly skilled at using the Internet. Must learn effectively with computer-based and/or online training.
  • Flexibility:  Demonstrates adaptability and openness to alternative solutions and flexibility when interacting with others, understanding their attitudes, needs, interests, and perspectives.
  • Inclusiveness:  The ability to network and partner with all internal and external stakeholders including broad and diverse representation of private/public and traditional/non-traditional community organizations.

Skills and Education

  • Bachelor’s degree, or applicable professional experience, required
  • Minimum 3 to 5 years’ experience in a healthcare organization or insurance environment

Benefits               Competitive benefit package

Salary                    Commensurate with experience

Aspire Health Plan is an equal opportunity employer.

Assigned Work Hours:

Position Type:

Regular

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!

Apply Online