The Enrollment Quality Coordinator performs quality assurance checks on transactions within the Enrollment and Billing department. This position provides the department with corporate metrics and reports the metrics to management.
ESSENTIAL FUNCTIONS OF THE ROLE
Examines and documents processes, identifies key controls and evaluates the adequacy and effectiveness of management controls in comparison to department performance goals.
Performs quality review checks of enrollment applications, group set-ups, billing and reconciliation, member letters and identification cards. Reviews and documents CSFs to ensure completeness and that customer needs are expeditiously met.
Compares membership data against documentation for accuracy and completeness. Conducts enrollment and billing reviews and audits to verify accuracy of membership and billing.
Recognizes noncompliance activities with organizational policies and procedures. Evaluates causes of inaccuracy, informs management and/or suggests training needs. Reviews summary findings with supervisors and management in a clear, concise and professional manner.
Performs internal reviews of data, eligibility and report results. Completes and maintains required forms in compliance with department policies and procedures.
Maintains the department's policies and procedures library. Examines and documents processes. Maintains and updates departmental flowcharts and Standard Operating Procedures.
Reports department metrics to management for their use in calculating if the department meets standards. Creates additional metrics, as needed, including establishing process to collect and report additional metrics.
KEY SUCCESS FACTORS
One to two years Amisys experience, data collection, metric reporting, statistics, and measurement of data preferred.
Ability to maintain a positive professional relationship with staff and all levels of management.
Demonstrated ability to maintain strict confidentiality at all times.
Ability to exercise good judgment, attention to detail, integrity, dependability, objectivity, and proven data-based skills.
Excellent communication skills and computer knowledge. Proven ability in MS Excel required.
Our competitive benefits package includes the following
Immediate eligibility for health and welfare benefits
401(k) savings plan with dollar-for-dollar match up to 5%
PTO accrual beginning Day 1
Note: Benefits may vary based upon position type and/or level
Baylor Scott & White Health (BSWH) is the largest not-for-profit health care system in Texas and one of the largest in the United States. With a commitment to and a track record of innovation, collaboration, integrity and compassion for the patient, BSWH stands to be one of the nation’s exemplary health care organizations. Our mission is to serve all people by providing personalized health and wellness through exemplary care, education and research as a Christian ministry of healing. Joining our team is not just accepting a job, it’s accepting a calling!