Senior Operations Commission Support Specialist - Medicare Job at HealthPlanOne, Trumbull, CT

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  • HealthPlanOne
  • Trumbull, CT

Job Description

**Please note the requirement of Medicare experience before applying**

The Senior Medicare Operations Commissions Support Specialist is a critical liaison between operations and finance, responsible for researching discrepancies in carrier policy statuses and commission payments that are identified by the finance team. This role builds strong working relationships with carrier contacts and provides insight regarding incorrect policy statuses and commissions through internal and carrier audit research, working with the Director of Operations Support to remedy all inaccurate information on internal systems.

Supervisory Responsibilities: None

Duties/Responsibilities:

  • Examines groups of policies by carrier and coverage type to assist finance in determining root cause for inaccurate statuses and payments.
  • Has a thorough knowledge of carrier commission and override schedules by product type and uses this knowledge to help determine which commission payments being researched need to be challenged with the carrier.
  • Utilize various reports, carrier portals and internal systems to conduct research
  • Identify discrepancies and the cause of missing payments
  • Create and manage carrier audit templates directly with carriers, tracking results of their research as responses are received
  • Responsible for updating the CRM via template imports to change policy statuses as needed and correct any discrepancies.
  • Work closely with both operations and finance on a regular basis to gain successful results in identifying missing carrier commission payments
  • Provide audit result reporting and communication on a regular cadence to all key stakeholders regarding progress
  • Acts as a backup for updating of the enrollment maintenance system and distribution of follow-up reconciliation reporting to team to work
  • Works in tandem with other team members to efficiently and accurately work duplicate policy reporting on a weekly basis
  • Works on ad-hoc projects within the Operations Support Team
  • Perform other related duties as assigned

Required Skills/Abilities:

  • High School Diploma or equivalent
  • 5-7 years Medicare Insurance carrier experience
  • 5+ years’ experience in an analytical role requiring critical thinking and problem solving
  • 5+ years commission reconciliation experience and understanding of commission Schedules
  • Advanced Excel experience including VLOOKUP, pivot tables, Macro and basic formulas
  • Capable of navigating data bases, CFM systems
  • Strong attention to detail, highly organized
  • Ability to meet deadlines in a dynamic environment
  • Strong written and verbal communication skills
  • Must be self-directed and able to work well independently as well as part of a team
  • Strong time management and organization skills
  • Ability to multitask

Preferred Skills/Abilities:

  • Bachelor’s degree
  • Finance and operations experience

Physical Requirements:

  • Must be able to remain in a stationary position (e.g., sitting or standing) for extended periods of time, typically in a cubicle environment (constant noise, fluorescent overhead lighting)
  • Frequent use of a computer, dual monitors, keyboard, mouse, and other standard office equipment such as a telephone, copier, and printer.
  • Must be able to communicate effectively, including exchanging information in person, in writing, by telephone, email or video conferencing.
  • Visual and auditory acuity required to perform job duties effectively, including reading, writing, and interpreting information on screens or in print.
  • Hand dexterity, fine motor skills needed to operate a keyboard and mouse efficiently
  • Reach with hands and arms occasionally

For Hybrid Roles:

  • Must be able to commute to an office setting as required, which may include walking short distances and navigating an office environment.
  • Occasionally moves about the office to access files, office machinery, and meet with others.

Equal Employment Opportunity (EEO) is a fundamental principle at HealthPlanOne, where employment is based upon personal capabilities and qualifications. HealthPlanOne does not discriminate because of actual or perceived sex, sexual orientation or preference, gender identity, gender, transgender, race, color, religion, national origin, creed, citizenship status, ancestry, age, marital status, pregnancy, childbirth or related medical conditions, medical conditions including genetic characteristics, mental or physical disability, military and veteran status, or any other protected characteristic as established by law. HealthPlanOne requires the necessary drug testing and background checks as part of our pre-employment practices. If you need assistance or an accommodation due to a disability, please contact us to request accommodation at accommodations@hpone.com

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