ജോലി വിവരണം

About the Role

Imagine360 is looking for a dedicated Administrative Support Specialist to join their workforce remotely. This position entails managing and supporting regulatory eligibility reporting, handling data administration, and conducting operational audits across multiple claims management systems. The selected individual will be responsible for preparing and submitting mandatory state and federal reports, including vaccine assessments, health care surcharges for New York and Massachusetts, and CMS Section 111 reporting, alongside investigating and rectifying discrepancies.

Key Responsibilities

Manage and file vaccine assessment reports as required by states, adhering to monthly, quarterly, or annual deadlines for all claims systems.
Coordinate with finance and client banking teams regarding assessment fee payments and client reimbursements.
Maintain and track the status of government reports for applicable states.
Submit monthly surcharges for New York and Massachusetts claims systems, liaising with claims support and banking departments for payment processing and reimbursements.
Prepare and file quarterly CMS Section 111 reports accurately and on time per system, following prescribed SOPs.
Process responses from CMS, address errors, and oversee correction efforts by working closely with configuration, plan build, and eligibility teams prior to subsequent filings.
Assist the EDI specialist in auditing new and updated 834 files before production release.
Support new business implementation tasks including census file creation, SEI creation, and auditing before launch.
Engage and communicate effectively with internal teams and external regulatory bodies, vendors, clients, or brokers to resolve issues related to reporting files.
Participate in required training sessions, coaching, and team meetings.
Execute additional assignments and projects as directed, ensuring all activities comply with HIPAA and regulatory standards.

Qualifications and Experience

Minimum of two years’ experience in reporting, operational roles, back or front office functions, or customer service; or equivalent combination of education and experience.
High School Diploma or GED is mandatory.
Background in Health Care Administration and prior CMS experience are advantageous.

Skills and Competencies

Proficient computer skills with prior use of Microsoft Office suite;
Advanced expertise in Excel and list manipulation;
Working knowledge of Word, PowerPoint, Visio, and CoPilot;
Ability to analyze and interpret extensive datasets efficiently;
Strong organizational skills to manage deadlines and meet company standards;
High accuracy and attention to detail;
Effective verbal and written communication abilities to interact comfortably at all organizational levels and externally;
A collaborative mindset and team-oriented approach.

Employee Benefits

Various health plan options available;
Employer-covered premiums for disability and life insurance;
Parental leave benefits;
Starting with 20 days paid time off plus 10 paid holidays annually;
Tuition reimbursement program;
401k with company contributions;
Company-paid short and long-term disability insurance along with life insurance;
Invitation to engage in professional development and continual learning;
Opportunities to support and participate in diversity and inclusion initiatives.

Additional Information

Imagine360 has established a health plan solution company leveraging over 50 years of expertise in self-funded healthcare. The company has a reputation for assisting thousands of employers in significantly reducing healthcare costs. The approach focuses on providing highly customized, member-centric solutions contrary to generic PPO insurance plans. Imagine360 is an equal opportunity employer, ensuring fair employment practices regardless of race, creed, gender identity, disability, or veteran status.

Recruitment agencies should note that only agencies authorized for a specific vacancy will have their candidate referrals accepted. Direct submissions to hiring managers without prior consent will be treated as unsolicited, with no fees paid.

Administrative Support Specialist