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Agency Management Analyst
Ref No.: 18-11315
Location: Trenton, New Jersey
Work Authorization:US Citizen
Segment:State and Local
JOB OPENING TYPE:SONJ- New Request
JPAS:NO
Job Description
Will work with ADDP clientele on Marketplace insurance
Reviews and processes HIPP/HICP applications; assesses eligibility for program services based on established policies and procedures; ensures completeness, enters eligible applications in database; prepares and issues clients' insurance premium payments/vouchers in an efficient and timely manner, per policy; ensures timely payments of health insurance premiums; communicates timely with client and/or case managers to ensure current insurance premium coverage;

Conducts ongoing (every 6 months) information searches in electronic or manual files for continued ADDP eligibility; sorts, indexes and files documents according to established guidelines and procedures; maintains essential electronic and paper files for assigned caseload as required by policy;

Provides front-line and behind the scenes customer and other support services involving the review, processing and issuance of program documents; provides varied information to clients/case managers regarding program and services; handles the most complex and/or sensitive client issues; requests; complaints and functions;

Maintains essential electronic/manual records and files per policies and procedure to ensure audit compliance; Will be required to learn to utilize various types of electronic and/or manual recording and computerized information systems used by the agency, office, or related units.

Assists with weekly/monthly/quarterly/annual HIPP utilization data analysis and report summaries.

Will be required to learn to utilize various types of electronic and/or manual information systems used by the program including but not limited to the HIPP Database; CareWare; MOLINA; Citrix and DMAHS.

SKILLS
Communication:
Knowledge of and ability to communicate with health insurance providers and clinical personnel regarding eligibility and requirements for health insurance coverage.

Communicates timely with client and/or case managers to ensure current insurance premium coverage;

Provides front-line and behind the scenes customer and other support services involving the review, processing and issuance of program documents;

Provides varied information to clients/case managers regarding program and services;
Handles the most complex and/or sensitive client issues; requests; complaints and functions.

Organization:
Ability to collect and secure, following all HIPAA guidelines, protected health information;

Precise documentation and tracking of applications, eligibility, payments, etc. to ensure compliance with OMB audits;

Ability to track and reconcile batch and individual insurance payment and request reimbursement for overpayment.

Computer:
Will be required to learn to utilize various types of electronic and/or manual information systems used by the program including but not limited to the CareWare; MOLINA; Citrix and Division of Human Services.

Education:
BA or BS degree
Knowledge of health insurance industry preferred