Mgr Membership Acctg & Elig

Health Net, Inc. (NYSE: HNT) is among the nation’s largest publicly traded managed health care companies. Health Net’s mission is to help people be healthy, secure and comfortable. The company’s POS, HMO, insured PPO, behavioral health and government contracts subsidiaries provide health benefits to more than 7 million individuals. For more information on Health Net, Inc., please visit the company’s Web site at www.healthnet.com  JOB SUMMARY: 

This position plans and organizes the activities of staff to maintain group and member level eligibility, premium rates and benefit information, as well as payment allocations, reconciliations, collections, and other membership records as assigned. This position is responsible for several members associated with many employer groups. The span of control of this position within Membership Accounting is limited by specified geographic limits. ESSENTIAL DUTIES AND RESPONSIBILITIES:Manages and monitors staff activities through subordinate supervisor to maintain accurate and current membership eligibility database and to control aged receivables in accordance with departmental guidelines and goals.Manages staff in researching and resolving problems involving membership exceptions, dues allocation and billing. Directs staff in reconciliation of discrepancies and resolution of account billing problems.Ensures review of aging of accounts, determines overdue accounts and directs collections activities.Ensures effective handling of internal and external inquiries concerning billing, rates, and members.Determines departmental goals, procedures, and performance standards.Ensures compliance of all federal, state, and company regulations as they pertain to various products.

REQUIREMENTS:


Education:
Bachelor’s degree in Accounting, Business Administration, or a related field; or equivalent work experience

 

Certification/License:

 

Experience:

Five years progressive experience in membership eligibility, billing and receivables within HMO/health care industry required

Three years experience in a supervisory position

 

Knowledge, Skills & Abilities:

Demonstrates supervisory and communications skills

Demonstrates ability to analyze, apply, interpret and communicate policies, procedures and regulations

 

OR





Any combination of academic education, professional training or work experience, which demonstrates the ability to perform the duties of the position.

 





Health Net, Inc. supports a drug-free work environment and requires pre-employment background and drug screening.





 





Health Net and its subsidiaries are an Equal opportunity/Affirmative Action Employer M/F/V/D.