Blue Cross and Blue Shield of Louisiana Jobs

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Blue Cross and Blue Shield of Louisiana Director, Enrollment & Billing in Baton Rouge, Louisiana

We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities. We invite you to apply for a career with Blue Cross.

POSITION PURPOSE

The Enrollment and Billing Director is responsible for providing strategic direction and operational oversight for the eligibility and enrollment of groups and/or individual members within their assigned customer segment. Responsible for ensuring the successful execution of billing, premium collection, cancelation, reconciliation and other enrollment and eligibility related operations. Directs assigned staff and is responsible for driving effective and efficient operational processes and procedures based on industry standard internal and external metrics.

NATURE AND SCOPE

  • Manages People

  • This role directly manages workers

  • This role directly manages these jobs: MANAGER, ENROLLMENT & BILLING

  • This role reports to this job: VP, BENEFIT OPERATIONS - ENROLLMENT & BILLING

  • Necessary Contacts: In order to effectively fulfill this position the incumbent must be in contact with:Regional Directors, District Office Personnel, Sales Representatives, Area offices, Marketing, Underwriting, Corporate Compliance, Customer Service, Business Engineering team, Plan Performance, Information Technology, Claims, Coding Units, Legal, Contract Compliance, Finance, and other departments in BCBSLA as needed.All levels of organizational leadership from front line staff and up through the organization’s Senior Management TeamExternal contact may include; Subscribers, other Blue Cross Blue Shield Plans, Consultants, Agents, Brokers, Group Leaders and vendors.

QUALIFICATIONS

Education

  • Bachelor's is required

  • Master's Degree or continuing education within the insurance and/or healthcare industry preferred

  • CLU, or FLMI certification preferred

  • Continuing education within the insurance and/or healthcare industry preferred

  • Four years of related experience can be used in lieu of a Bachelor’s degree.

Work Experience

  • 7 years of managing direct customer support operations required

  • 3 years of people management experience and demonstrated leadership skills. Experience can run concurrently required

  • Experience in the healthcare industry operations is preferred, particularly within the health insurance sector

  • Experience with identifying, implementing, monitoring and managing business area operational and financial controls required

Skills and Abilities

  • Working knowledge of relative software, including the ability to use data processing resources to develop and improve processing systems

  • Strong analytical, communication, and managerial skills required

Licenses and Certifications

  • None Required

ACCOUNTABILITIES AND ESSENTIAL FUNCTIONS

  • Directs the department operations and staff to ensure timely and accurate enrollment, billing, and processing of new and renewing health plan customers, annual budget planning and management, and operational compliance. Actively mentors and coaches department team members.

  • Reviews and monitors the effectiveness of the departmental procedures and practices to proactively manage and improve member enrollment and premium billing for all BCBSLA individual and/or group customers.

  • Develops highly collaborative working relationships with key organizational support areas (e.g. HR, IT, Audit, Project Management, and Finance) and process dependent operational areas to jointly develop or adjust procedures and/or practices that require coordination and handoffs with partner operational areas (Underwriting, Marketing, Claims, Customer Service, etc.) related to rate increases, benefit changes, new products, operational transactions, and special billing situations.

  • Provides oversight and directs delinquency resolution activities of collection and reinstatement to ensure operational practices are compliant with applicable regulatory requirements and company policies.

  • Formulates and administers departmental policies.

  • Develops departmental goals and objectives that ensure accurate and efficient operations are in place to serve our customers and practices remain compliant with corporate policies.

  • Ensures fundamentally sound operational controls are in place, monitored, and managed to pass internal and external audit reviews and annual control reviews associated with annual corporate audits (e.g.SOC1, Model Audit Rule (MAR), etc.)

  • Establishes relevant operational metrics and monitors work performance to ensure required divisional, Association, other applicable performance standards and applicable Service Level Agreements (SLAs) are met or exceeded. Monitors and manages third party performance measures to ensure compliance and timely corrections when out of compliance with agreed upon service levels.

Additional Accountabilities and Essential Functions

The Physical Demands described here are representative of those that must be met by an employee to successfully perform the Accountabilities and Essential Functions of the job. Reasonable accommodations may be made to enable an individual with disabilities to perform the essential functions

  • Perform other job-related duties as assigned, within your scope of responsibilities.

  • Job duties are performed in a normal and clean office environment with normal noise levels.

  • Work is predominately done while standing or sitting.

  • The ability to comprehend, document, calculate, visualize, and analyze are required.

An Equal Opportunity Employer

All BCBSLA EMPLOYEES please apply through Workday Careers.

PLEASE USE A WEB BROWSER OTHER THAN INTERNET EXPLORER IF YOU ENCOUNTER ISSUES (CHROME, FIREFOX, SAFARI)

Additional Information

Please be sure to monitor your email frequently for communications you may receive during the recruiting process. Due to the high volume of applications we receive, only those most qualified will be contacted. To monitor the status of your application, please visit the "My Applications" section in the Candidate Home section of your Workday account.

If you are an individual with a disability and require a reasonable accommodation to complete an application, please contact recruiting@bcbsla.com for assistance.

Blue Cross and Blue Shield of Louisiana performs background and pre-employment drug screening after an offer has been extended and prior to hire for all positions. As part of this process records may be verified and information checked with agencies including but not limited to the Social Security Administration, criminal courts, federal, state, and county repositories of criminal records, Department of Motor Vehicles and credit bureaus. Pursuant with sec 1033 of the Violent Crime Control and Law Enforcement Act of 1994, individuals who have been convicted of a felony crime involving dishonesty or breach of trust are prohibited from working in the insurance industry unless they obtain written consent from their state insurance commissioner.

Additionally, Blue Cross and Blue Shield of Louisiana is a Drug Free Workplace. A pre-employment drug screen will be required and any offer is contingent upon satisfactory drug testing results.

JOB CATEGORY: Insurance

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