Description

The Bilingual Case Management Analyst III is responsible for efficient and timely hands-on troubleshooting, remediation, coordination, escalation, tracking and management. Also responsible for conducting research, workflow investigations, business procedures and making recommendations for improvement. The analyst will interact with consumers, Agent Brokers and providers via phone and email.

What will I get to do?

• Providing excellent customer service to consumers by adhering to CMS policy and identifying and analyzing customer (issuers and consumers) inquiries and processing disputes in both English and Spanish languages, through phone calls, and emails.
• Applying triage, research, collaboration, and technical knowledge to resolve transaction and processing issues through analysis and using decision matrices.
• Analysis of discrepancies in the eligibility reconciliation process for multiple stakeholders using defined data sources and following Standard Operating Procedures
• Responsible for continuous process improvement of the reconciliation process, and recommending changes or enhancements to processes, as well as the integration with technology.
• The analyst will provide content and feedback to and for partnering with training staff on training stakeholders on triaging transactions and the reconciliation process.
• Experience as a business analyst performing collaborative work with customers and other stakeholders, gathering and documenting business requirements to achieve the project goals, will complement the role as a case analyst.
• Employee is expected to undertake any additional duties as assigned by manager.

Minimum Qualifications

• Bachelor’s Degree or equivalent OR 4 years of relevant experience in lieu of degree.
• Fluent in English and Spanish language; both written and verbal.
• Experience analyzing discrepancies using human judgement or decision making.
• Experience with federal data or projects (including, but not limited to agencies such as CMS, IRS, DOD, VA, SSA or another federal agency).
• Must be a US Citizen or Authorized to work in the US (if not a citizen) and a resident of the US for at least 3 years within the last 5 years.

Candidates that do not meet the required qualifications will not be considered.

Other Job Specific Skills

• Experience with Affordable Care Act
• Strong written and oral communication skills
• Advanced customer service telephone skills and the willingness to make outbound and receive inbound telephone calls
• Proficiency in Microsoft Word, Excel, Power Point, SharePoint
• Experience with Federal contracts desired
• Experience with 834 enrollment transaction process desired
• Assisting individuals with enrollment into health insurance coverage, working with in-person assisters, or researching Marketplace eligibility and enrollment processes and policies