Administrative Support Specialist

Summary

Imagine360 is a health plan solution company that combines over 50 years of self-funding healthcare expertise. They are seeking an Admin Support Specialist responsible for supporting regulatory eligibility reporting, data administration, and operational audit activities across multiple claims systems within the organization.

Responsibilities

• Ownership Of State And Federal Required Eligibility Reporting
• State Vaccine Reporting
• File and report all required state vaccines assessments timely (monthly, quarterly, annually) for all claims systems
• Correspond with finance and client banking on state assessments fee payments and client reimbursement
• Track and maintain government reporting status for all applicable states
• NY/MA surcharges
• File monthly NY and MA surcharges with states for all applicable claims systems
• Correspond with claims support and client banking on surcharge payments and client reimbursement
• Track and maintain government reporting status
• CMS 111 reporting
• Create, File and submit quarterly CMS section 111 reporting following system specifications and SOPs accurately and timely on a quarterly basis, per system
• Process CMS response files
• Review CMS errors and own the correction process
• Partner with configuration, plan build, eligibility and others to resolve CMS errors before next filing
• Support EDI/834 implementation and audit
• Support EDI specialist with auditing new and changing 834 files before releasing to production
• Support New Business implementation and audit
• Support New Business specialist with common census file creation, SEI creation, and audit before releasing to production
• Communicate with internal stakeholders, and externally with regulatory bodies, vendors, clients and/or brokers to resolve file concerns and issues
• Participate in required training and meetings, one on one coaching sessions, and team huddles
• Perform other duties and projects assigned
• Perform all tasks in accordance with HIPAA guidelines

Skills

• 2 years of reporting, operations, back or front office and/or customer service experience required, or equivalent combination of education and experience
• High School Diploma or GED required
• Strong PC skills, prior experience with MS Office required
• Advanced MS Office experience specific to Excel and Lists
• Moderate MS Office experience specific to Word, PowerPoint, Visio, and CoPilot
• Ability to interpret and manipulate large amounts of data, making sense of transactions
• Ability to manage time, ensuring all requirements are met by company standards
• High level of accuracy and attention to detail
• Strong verbal and written communication skills, comfortability in communicating at various levels with internal and external stakeholders
• Team player able to collaborate with other departments
• Health Care Administration background a plus!
• Prior CMS Experience a plus!

Qualifications

Must Haves

• 2 years of reporting, operations, back or front office and/or customer service experience required, or equivalent combination of education and experience
• High School Diploma or GED required
• Strong PC skills, prior experience with MS Office required
• Advanced MS Office experience specific to Excel and Lists
• Moderate MS Office experience specific to Word, PowerPoint, Visio, and CoPilot
• Ability to interpret and manipulate large amounts of data, making sense of transactions
• Ability to manage time, ensuring all requirements are met by company standards
• High level of accuracy and attention to detail
• Strong verbal and written communication skills, comfortability in communicating at various levels with internal and external stakeholders
• Team player able to collaborate with other departments

Nice to Haves

• Health Care Administration background a plus!
• Prior CMS Experience a plus!

Benefits

• Multiple Health plan options
• Company paid employee premiums for disability and life insurance
• Parental Leave Policy
• 20 days PTO to start / 10 Paid Holidays
• Tuition reimbursement
• 401k Company contribution
• Company paid Short & Long term Disability plus Life Insurance
• Professional development initiatives / continuous learning opportunities
• Opportunities to participate in and support the company's diversity and inclusion initiatives