Centene Corporation Eligibility Specialist II in Long Island City, New York
You could be the one who changes everything for our 26 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
Position Purpose: Maintain membership records system related to the qualifications a person or dependent must meet for coverage under the State contract or agreement
• Provide timely, efficient support for the eligibility load process and coordinate with IT to resolve issues
• Research and correct errors in membership and PCP (Primary Care Physician) data input within the Amisys system
• Complete monthly reconciliation of remittance files and resolve any discrepancies
• Collaborate with IT and other functional departments to develop and implement new products or changes to existing products, including UAT testing
• Coordinate the provider capitation process to ensure accurate and timely payments to providers
• Participate in eligibility release planning to identify any system changes and ensure files are complete and process timely
• Provide input on process improvement initiatives and update policies and procedures for eligibility and enrollment related activities
• Develop training materials and train new staff on eligibility and enrollment procedures
• Generate internal ad-hoc reports and analysis as needed.
Education/Experience: High school diploma or equivalent. 4+ years of member enrollment, membership eligibility, member services, or data analysis experience. Knowledge of Medicaid managed care programs and practices, preferably for the assigned State. Experience with the Amisys and CRM system preferred.
Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
TITLE: Eligibility Specialist II
LOCATION: Long Island City, New York
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