APN Consulting Inc
Edison, NJ
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Job Description :
APN Consulting has an immediate need for a direct client requirement:
Position Title: Technical Eligibility Manager
Location: Remote
Duration: 3 months
Under the direction of the Vice-President Technical Benefit Admin & Eligibility Implementation, the Technical Eligibility Manager is responsible for the oversight of the Eligibility Team including accuracy, quality, and operational efficiency. They are responsible for overseeing key revenue impacting processes within the business model as well as providing direction, coaching, and support to the Eligibility Team staff. Client is a mission driven company, and our leaders are energetic, proactive and are responsible to lead by example, representing our corporate values in everything we do. Work will be measured by achievement of business objectives and progress towards strategic goals leading to improved productivity or profitability.
Essential Duties and Responsibilities:
  • Support and provide guidance to staff on established Leadership key objectives.
  • Lead, motivate and develop staff to perform as a cohesive, operations-oriented team.
  • Monitor team member performance through observation and analysis of data and metrics. Ensure eligibility team service level agreements across all areas are met or exceeded.
  • Resolve eligibility escalations and communicate outcomes to other departments while keeping to established timelines.
  • Ensure a positive work environment based on respect and continuous learning.
  • Participate in hiring decisions in collaboration with the Director. Responsible for organizing the onboarding and orientation of new hires.
  • Utilize Excel for data analysis and reporting
  • Expert knowledge of 270/271 transactions
  • Maintain knowledge of industry standards for insurance verification
  • Understand and adhere to HIPAA policies, procedures, and regulation, maintaining strict confidentiality
  • The time spent on each responsibility reflects an estimate and is subject to change dependent on business needs.
Qualifications Expected for Position
  • 2+ years management experience
  • Bachelor degree or equivalent work experience in a related field
  • Minimum of 5+ years of work experience in related areas
  • Demonstrated ability to lead and motivate team members
  • Must be able to work cross-functionally to communicate vision, strategy, as well as ensure process alignment and adherence
  • Process oriented
  • Strong problem-solving skills; demonstrated ability to facilitate mutually agreeable solutions
  • Demonstrated ability to successfully partner with others to establish and achieve KPIs
  • Excellent follow up and proactive attitude
  • Strong organization, administrative, and communication skills (written and verbal).
  • Advanced Excel skills, with the demonstrated ability to write formulas, perform VLOOKUP, pivot tables, etc.
  • Expert knowledge of EDI 270/271 transactions and insurance eligibility verification
  • Strong verbal, written and interpersonal skills, with an affinity for teamwork
  • Good organizational, multi-tasking and time management skills, with excellent attention to detail
  • Comfort and success working in a fast-paced environment with tight deadlines
  • A strong work ethic, resourcefulness and the motivation to succeed
  • A proactive approach to identifying and resolving issues


Client : APN Consulting
             

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