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American IT Staff


Ranchi College Rd, Sarna Toli, Hatma, Ranchi, Jharkhand 834008, India Full-time

American IT Staff is hiring a Remote Enrollment Coordinator

Job Description

  • Handles incoming customer calls and assignments in a professional manner
  • Works on assigned/required weekends and after-hours during open enrollment season
  • Handles and processes all member enrollment, disenrollment, and cancelation requests; Duties include but are not limited to:
    • Prints all incoming applications and disenrollments from fax or electronic enrollment via enrollment site, or OEC (mailed in (scan), emailed in)
    • Verifies and print beneficiary eligibility evidence for Part A/B, Medical, and Wipro (info crossing)
    • Date stamps, sorts and combines applications with eligibility into PDF packets. (Manage each application in individual folders for back up)
    • Screens all incoming application and follow up with the broker for all discrepancies / missing information to ensure the application is complete
    • Pre-logs application into the enrollment system for tracking and confirmation purposes
    • Processes enrollment applications: Data entry of prospective members into the enrollment system for completed enrolments that have been evaluated with an assigned election type/code.
    • Generates submission report and uploads enrollment application to member profile daily
    • Print auto-generated notices (OEV, Client, REJ, CAN, RFI, etc.). Upload, call log, and mail out.
    • Verification of members with Medical eligibility through online verification for the DSNP monthly process
    • Notifies Broker Relations Department when a questionable or non-compliant pattern is identified with specific brokers
    • Coordinates outbound calls with Member Services Department for research or obtaining additional information, Participating in Team chats, emails, and meetings related to Department operations
  • Conducts any necessary research on questionable applications by working with supervisory staff.
  • Coordinates with the Member Services Department to properly track the mailing of ID cards, and all other applicable letters/notices to members after enrollment completion
  • Responsible for handling the prospective Member calls transferred/received from Member Services Department and/or other departments. Inform the Supervisor/Manager of issues encountered and provide resolution promptly
  • Assists in translation and proofreading upon request from upper management and the marketing department

Qualifications

  • Education: At least a high school diploma; preferable a college degree
  • Experience: Preferably with one (1) year of hands-on Medicare enrollment/disenrollment background; or equivalent general healthcare background health plan, hospital administrative work, or doctor's office front desk. Preferably has some experience with healthcare member services or general customer service
  • Bilingual in English and or Korean/Chinese spoken and written required – must be able to communicate effectively and professionally. Language will be tested for fluency
  • Good organization skills, detail-oriented
  • Able to work efficiently and can follow instructions well
  • Computer skills including Word processing and Excel

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American IT Staff is hiring a Remote Mainframe Developer with WGS Claims exp.

Job Description

  • Maintains active relationships with customers to determine business requirements and leads requirements gathering meetings.
  • Ability to provide estimates and make recommendations.
  • Participates in PI planning and Scrum calls for agile projects
  • Owns the change request process and may coordinate with other teams as necessary
  • Develops and owns list of final enhancements.
  • Develops and defines application scope and objectives and prepares technical and/or functional specifications from with programs will be written.
  • Prepare high level and detailed technical design, coding, code reviews.
  • Ensures unit test is completed and meets the test plan requirements, system testing is completed, and system is implemented according to plan.
  • Assesses current status and supports data information planning.
  • Coordinate development with offshore team.
  • Coordinates on-call support and ensures effective monitoring of system.
  • Maintains technical development environment.
  • Mentors others and may lead multiple or small to medium sized projects.
  • Facilitates group sessions to elicit complex information on requirements clarification, design sessions, code reviews and troubleshooting issues.
  • Supports vendor evaluation.
  • Expert level experience with business and technical applications, or any combination of education and experience, which would provide an equivalent background. ·

Qualifications

  • 5+ Years’ experience in designing, developing, testing, and deploying COBOL, SQL, JCL, IMS DB/DC, DB2.
  • Expert with Mainframe, SOA services and Mainframe integration
  • Hands-on experience in TSO/ISPF, Endevor, File Manager, File Manager IMS utility, File Manager DB2 utility, SDSF, IOF, TABLE BASE, Fault Analyzer, IBM Debug.
  • Expertise in Healthcare Claims, Provider/Pricing Domain.
  • Advanced analytical capabilities.
  • Well versed in JIRA and Confluence.
  • Understands the Agile concept and hands-on experience working on Agile projects is preferred
  • Experience working in application maintenance support and understands the ITIL processes
  • Incumbent should also have the ability to mentor others, lead multiple projects and provide troubleshooting support.
  • Multi-dimensional required.
  • Multi database and/or multi language preferred.
  • Should have very Strong analytical and problem solving abilities to solve a wide range of difficult problems.
  • Strong communication skills: - written and oral.

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