Accenture is a leading global professional services company that helps the world’s leading businesses, governments and other organizations build their digital core, optimize their operations, accelerate revenue growth and enhance citizen services—creating tangible value at speed and scale. We are a talent- and innovation-led company with approximately 743,000 people serving clients in more than 120 countries. Technology is at the core of change today, and we are one of the world’s leaders in helping drive that change, with strong ecosystem relationships. We combine our strength in technology and leadership in cloud, data and AI with unmatched industry experience, functional expertise and global delivery capability. We are uniquely able to deliver tangible outcomes because of our broad range of services, solutions and assets across Strategy & Consulting, Technology, Operations, Industry X and Song. These capabilities, together with our culture of shared success and commitment to creating 360° value, enable us to help our clients reinvent and build trusted, lasting relationships. We measure our success by the 360° value we create for our clients, each other, our shareholders, partners and communities. Visit us at www.accenture.com. Job Description:The Medicare Enrollment Sr Analyst is responsible for Medicare enrollment processing, membership reconciliation, and ongoing member maintenance. This role ensures the timely submission of enrollment files to Centers for Medicare & Medicaid Services (CMS) and the accurate processing of daily and monthly CMS eligibility files.Key Responsibilities:
Accurately and promptly reconcile CMS monthly enrollment files by resolving member demographic and status discrepancies through the Revenue Reconciliation Process.
Submit discrepancies for correction to the CMS Retroactive Processing Contractor (RPC) when applicable.
Ensure compliance with CMS regulations by processing CMS DTRR transactions and sending required member correspondence within established timelines.
Develop a comprehensive understanding of the CMS MARx system and its application features.
Professionally interact with internal stakeholders by addressing questions and inquiries while representing the department effectively.
Document inconsistencies, issues, or concerns thoroughly for follow-up and resolution by internal support staff or software vendors.
Track the status of assigned tasks and resolve related problem issues to completion.
Assist in developing and maintaining desk-level procedures related to job functions, system usage, and application maintenance.
Complete Electronic Data Validation within CMS-required timeframes.
Work daily audits and reports within the department’s Service Level Agreements (SLAs).
Monitor and track assigned queues for timely resolution.
Perform additional duties as needed. "
Candidate should have a substantial enrollment processing and reconciliation understanding and knowledge of the MA MAPD methodologies.
Prior experience using Market Prominence is preferred.
Basic Qualifications:
Minimum of 3 years of experience processing Medicare enrollment transactions.
Preferred:
Bachelors Degree.
Expert in Microsoft Office Suite with knowledge of V-lookups and pivot tables.
Candidate should have a substantial enrollment processing and reconciliation understanding and knowledge of the MA MAPD methodologies.
Prior experience using Market Prominence is preferred.
Compensation at Accenture varies depending on a wide array of factors, which may include but are not limited to the specific office location, role, skill set, and level of experience. As required by local law, Accenture provides a reasonable range of compensation for roles that may be hired in California, Colorado, District of Columbia, Maryland, New York or Washington as set forth below.We accept applications on an on-going basis and there is no fixed deadline to apply.Information on benefits is here. (https://www.accenture.com/us-en/careers/local/total-rewards) Role Location Hourly Salary RangeCalifornia $26.20 to $63.13Colorado $26.20 to $54.52District of Columbia $27.93 to $58.08New York $24.28 to $63.13Maryland $24.28 to $50.48Washington $27.93 to $58.08Pay Transparency Info for Salary Range Request from Employee or Candidate:Accenture offers competitive pay to ensure that our people are compensated fairly and equitably. Compensation varies depending on a wide array of factors, which may include office location, role, skill set, level and experience. Generally, Accenture does not disclose base pay range information to our people unless required by law. Based on where you are located, you are not entitled to such information at this time.What We BelieveWe have an unwavering commitment to diversity with the aim that every one of our people has a full sense of belonging within our organization. As a business imperative, every person at Accenture has the responsibility to create and sustain an inclusive environment.Inclusion and diversity are fundamental to our culture and core values. Our rich diversity makes us more innovative and more creative, which helps us better serve our clients and our communities. Read more here (https://www.accenture.com/us-en/about/inclusion-diversity/us-workforce) Equal Employment Opportunity StatementAccenture is an Equal Opportunity Employer. We believe that no one should be discriminated against because of their differences, such as age, disability, ethnicity, gender, gender identity and expression, religion or sexual orientation.All employment decisions shall be made without regard to age, race, creed, color, religion, sex, national origin, ancestry, disability status, veteran status, sexual orientation, gender identity or expression, genetic information, marital status, citizenship status or any other basis as protected by federal, state, or local law.Accenture is committed to providing veteran employment opportunities to our service men and women.For details, view a copy of the Accenture Equal Employment Opportunity and Affirmative Action Policy Statement (https://www.accenture.com/content/dam/accenture/final/accenture-com/document/Annual-Policy-Statement-Regarding-EEO-2023-Applicant.pdf#zoom=50) .Requesting An AccommodationAccenture is committed to providing equal employment opportunities for persons with disabilities or religious observances, including reasonable accommodation when needed. If you are hired by Accenture and require accommodation to perform the essential functions of your role, you will be asked to participate in our reasonable accommodation process. Accommodations made to facilitate the recruiting process are not a guarantee of future or continued accommodations once hired.If you would like to be considered for employment opportunities with Accenture and have accommodation needs for a disability or religious observance, please call us toll free at 1 (877) 889-9009, send us an email (https://www.accenture.com/us-en/about/contact-us) or speak with your recruiter.Other Employment StatementsApplicants for employment in the US must have work authorization that does not now or in the future require sponsorship of a visa for employment authorization in the United States.Candidates who are currently employed by a client of Accenture or an affiliated Accenture business may not be eligible for consideration.Job candidates will not be obligated to disclose sealed or expunged records of conviction or arrest as part of the hiring process.The Company will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. Additionally, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the Company's legal duty to furnish information.
