Position Purpose: The Lead Membership Account Representative coordinates workflow and assists with supervision of unit staff to ensure allocation of payments, reconciliation and audit of employer group accounts.
Handles escalated and/or complex issues. Ensures quality and productivity goals are met by coaching, feedback and assistance with complex issues. Acts as a Subject Matter Expert on various committees in the department of company wide initiatives.
Allocates, calculates and processes complex and escalated employer group payments; reviews unapplied cash report for guidance.
Coordinates and monitors daily processing for the staff to maintain eligibility database within departmental guidelines and goals. Handles escalated calls/issues for the Membership Accounting Reps.
Monitors the unit's schedule for sufficient coverage. Reviews aging of forms, while continually re-prioritizing based on departmental needs.
Participates in the establishment and review of departmental goals and implements procedures and performance standards. Ensures goals are communicated to staff.
Prepares reports and documentation concerning departmental activities. Reviews weekly auditing reports.
Monitors processing, tracks and delegates work based on departmental goals, backlogs and ensures equitable distribution.
Reviews weekly auditing reports for accuracy and maintains accuracy and production tracking logs.
Works with staff to reconcile audit discrepancies and resolve eligibility questions. Reviews/analyzes returned audit tickets. Identifies training/performance gaps.
Ensures action plans are in place to reduce backlog and effect resolution to ongoing issues.
Mentors and trains new associates. Advises and/or counsels staff members on correct procedures.
Responds to phone calls from other service centers and internal units.
Encourages associates in the units to assist other units as necessary.
Education/Experience: Associate's Degree in Business or Health Care or related experience is preferred. Four years membership accounting or related experience.
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.