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Enterprise Solutions Inc. is currently looking to fill an urgent contract opportunity as Managed Care Analyst with the client based in Beverly Hills, CA 90211 Location. Please let me know if you are available for the same.

Kindly find the JD below and let me know if you are available for the same.
Job Title: - Managed Care Analyst

Job Location: - 200 North Robertson Boulevard Suite 112 Beverly Hills, CA 90211

Job Duration: 3+months (Temp to Perm)

Pay Rate: $32.50/hour on W2

Schedule: Day 5x8-Hour (08:00 - 17:00)

Job Description:

Hybrid/Remote Work - Training will be completed onsite and hybrid work schedule coordinated with department supervisor.

Job Duties and Responsibilities:

• Maintains database integrity in accordance with policies, procedures and guidelines as outlined by company policy. Researches and solves application problems to maintain a viable system.
• Maintains current in-depth knowledge of assigned applications’ functionality and participates in system upgrades and testing.
• Verifies member eligibility and benefits via health plan websites and/or other methods as appropriate.
• Completes benefit plan builds for all HMO Managed Care plans by completing specification imports with all appropriate benefits (copays, coinsurance, deductibles and MOOP).
• Responsible for contacting health plans for benefit interpretations and to obtain clarification for use in design.
• Works closely with EIS Personnel on EIS-related projects.
• Fosters two-way communication within department and with end-users.
• Uses Customer Relationship Management tool to communicate with internal departments to resolve issues and tasks pertaining to enrollment, eligibility and benefits and adhere to task turn-around times.
• Work eligibility work-queues for any eligibility and benefits issues.
• Determine coverage filing order using NAIC and CMS guidelines for Coordination of benefits.
• Works enrollment audit reports, and other system reports to make appropriate eligibility and benefit updates.
• Performs root cause analysis to determine issues related to eligibility and benefits or system errors
• Identifies issue trends and opportunities for improvement.

Education:

• High school diploma or GED required.
• Associates degree preferred.

Experience:

• 2 years Working with eligibility and benefits in a Managed Care setting Knowledge of CPT, HCPCS, and ICD-10 codes.
• 2 years’ Experience with EPIC preferred or other similar patient information system(s)
• 2 years Healthcare related office experience preferred.

Job Type: Contract

Salary: $30.00 - $32.50 per hour

Schedule:

• 8 hour shift
• Monday to Friday

Ability to commute/relocate:

• Beverly Hills, CA 90211: Reliably commute or planning to relocate before starting work (Required)

Experience:

• Managed Care: 2 years (Preferred)
• CPT, HCPCS, and ICD-10 codes.: 2 years (Preferred)
• EPIC: 2 years (Preferred)
• Healthcare offices: 2 years (Preferred)

Work Location: One location

Speak with the employer
+91 6692677425

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