Top 35427 Jobs in Woonsocket, Ri

Eligibility & Revenue Operations Representative- Hybrid Schedule
Fallon Health —Worcester, MA
- $25 an hour
- Full-time
- Hybrid work
- Microsoft Excel
- Microsoft Access
- Basic math
14d
Sales - Entry Level
Trinity Solar —Woonsocket, RI
- $68,000 - $120,000 a year
- Bilingual
- 18 years or older
- Clean driving record
- Paid training
- Health insurance
Quick Apply
Mechanical Assembler - 1st shift
Distron Corporation —North Attleboro, MA
- $18 - $21 an hour
- Writing skills
- English
- High school diploma or GED
Quick Apply
Inside Sales Representative
Everett J Prescott Inc —Lincoln, RI
- Full-time
- Sales
- Office
- High school diploma or GED
- Paid holidays
- Disability insurance
Quick Apply
12d
Data Scientist - AI Trainer
DataAnnotation —Westborough, MA
- $50 - $100 an hour
- Part-time
- Remote
- Writing skills
- English
- Mid-level
- Flexible schedule
Quick Apply
Member Services Representative Full and Part Time
Planet Fitness - Woonsocket, Coventry,Warwick, Cumberland —Woonsocket, RI
- Part-time
- 18 years or older
- Computer literacy
- High school diploma or GED
Quick Apply
REPOSSESSION CAMERA CAR
Skyline Recovery Service —Providence, RI
- $18 - $20 an hour
- Full-time
- Background check
- Clean driving record
- English
- Health insurance
- Dental insurance
Quick Apply
Assistant Store Manager
The Paper Store —Bellingham, MA
- $23 - $30 an hour
- Weekends as needed
- Mid-level
- Cash register
- Ability to lift 50 pounds
Quick Apply
Subaru Automotive Parts Counter Person
Anchor Auto Group —North Smithfield, RI
- $40,000 - $70,000 a year
- Full-time
- Dealership
- Driver's License
- Organizational skills
- Health insurance
- 401(k)
Quick Apply
Purchasing Assistant Data Entry Part Time
Carbone Floral Distributors —Cranston, RI
- $1 - $100 an hour
- Extended hours
- Background check
- Customer service
- Office
Quick Apply
Activities Assistant
Blaire House of Milford —Milford, MA
- $18.50 an hour
- Part-time
- Background check
- Skilled nursing facility
- English
- 401(k)
- Paid time off
Quick Apply
14d
Assistant Store Manager
Birkenstock USA —Wrentham, MA
- $22 - $26 an hour
- Email
- Merchandising
- In-person
- Retail management experience
- Health insurance
- Paid time off
Quick Apply
Host / Hostess
Ninety Nine Restaurant & Pub —Milford, MA
- $15 - $17 an hour
- Part-time
- Bar
- Food service experience
- Restaurant
- Disability insurance
- Health insurance
Quick Apply
Distribution Tech - Purchasing and Stores
Landmark Medical Center —Woonsocket, RI
- Full-time
- Computer literacy
- High school diploma or GED
- Computer skills
Surveillance Officer - Full Time
Bally's Twin River Lincoln —Lincoln, RI
- $25 an hour
- Full-time
- Computer literacy
- High school diploma or GED
- Entry level
Quick Apply
Customer Service Associate I
Dollar Tree —Woonsocket, RI
- $16.00 - $16.50 an hour
- Part-time
- High school diploma or GED
- Ability to lift 50 pounds
- Grocery store experience
- Health insurance
- Dental insurance
Retail Store Associate
Savers/Value Village —Woonsocket, RI
- Part-time
- Entry level
- Health insurance
- Dental insurance
Quick Apply
SALES ASSOCIATE
Dollar General —Woonsocket, RI
- Part-time
- Merchandising
- High school diploma or GED
- Communication skills
Retail Sales Associate Part Time
PetSmart —North Smithfield, RI
- $16 - $24 an hour
- Part-time
- 18 years or older
- Maintenance
- Ability to lift 50 pounds
- Health insurance
- Tuition reimbursement
Member Services Full and Part Time Flexible Hours Fun Fast Paced Enviroment
Planet Fitness - Woonsocket, Coventry,Warwick, Cumberland —Woonsocket, RI
- $14.00 - $16.50 an hour
- Full-time
- 18 years or older
- Entry level
- Paid time off
- Flexible schedule
Quick Apply

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Eligibility & Revenue Operations Representative- Hybrid Schedule

Fallon Health -
Worcester, MA

Apply Now

Job Details

Full-time
$25 an hour
14 days ago

Qualifications

Confidential information handling
Microsoft Excel
Phone communication
Basic math
Employee relationship building
Administrative experience
High school diploma or GED
Typing
Productivity software
Office experience

Full Job Description

Overview:

About us:

Fallon Health is a company that cares. We prioritize our members—always—making sure they get the care they need and deserve. Founded in 1977 in Worcester, Massachusetts, Fallon Health delivers equitable, high-quality, coordinated care and is continually rated among the nation’s top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences, knowledge, self-expression, and unique capabilities allow us to better serve our members. We embrace and encourage differences in age, race, ethnicity, gender identity and expression, physical and mental ability, sexual orientation, socio-economic status, and other characteristics that make people unique. Today, guided by our mission of improving health and inspiring hope, we strive to be the leading provider of government-sponsored health insurance programs—including Medicare, Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)— in the region. Learn more at fallonhealth.org or follow us on Facebook, Twitter and LinkedIn.

Brief summary of purpose:

Pre-requisites for success in this position include Strong verbal & written communication skills including demonstrated excellence in telephone communication skills, strong organizational skills, computer skills. Performs all functions necessary to maintain accurate subsidiary accounts receivable and ensures accuracy of premium bills. Analyze/reconcile receivables balance for Commercial and Regulatory products to identify problems with payments and/or impose the delinquency process. Study the contractual terms and conditions to ensure payments received meet the contractual requirements.
Handles confidential customer information. Knowledgeable of plan policies, protocols, and procedures. Requires ability to work in a fast-paced environment with multi-disciplined staff. Consistently follows through on issue resolution. Strong multitasking abilities are essential along with taking accountability and understanding job functions can change based upon business needs. Initiates self-development via available company and industry educational opportunities

The Eligibility and Revenue Operations Representative is responsible for enrollment and billing maintenance, adhering to daily, weekly and monthly schedules and administrative related tasks.

Responsibilities:

Primary Job Responsibilities:

Provides knowledgeable responses to internal and external customer inquiries and concerns regarding enrollment and billing including, but not limited to, qualifying events, policies and procedures, ID cards, letter correspondence (including Outbound Education and Verification), selection of primary care physician, premium invoices, payment inquiries and general eligibility and financial maintenance.
Enters and maintains premium rates as provided by Actuarial and Regulatory Affairs (including Low Income Subsidy and Late Enrollment Penalties)
Reconciles membership and billing reports as required by CMS, MassHealth and Health Connector (both automated and manual) to ensure accuracy of information.
Communicate professionally to resolve discrepancies. Maintains the accuracy and integrity of the eligibility and premium tasks (including working data integrity reports on a daily basis).
Provides all necessary eligibility, enrollment and premium support to the Sales Finance, Product owners, and/or Regulatory Affairs, as needed.
Reports back all members who fit the criteria per the Medicaid requirement for TPL, Address, and rating category changes
Maintains current inventory and timely closure of all assigned issues and workload.
Process all transactions related to customer data in a timely and accurate manner. Escalates inventory backlog daily.
Maintains active and consistent availability on the phone system, as scheduled, for all lines of business both Commercial and Regulatory.
Partners with other departments to maximize the efficiency of shared work.
Meets internal/external deadlines and remains in compliance with CMS and EOHHS regulations
Prepare documented payment plans, and payment extensions at the request of customers and presents to Management for approval
Prioritizes daily and weekly work
Prepare balance forward notification and requests for payment history.
Collects premium for employer groups and individual members, including but not limited to written correspondence as well as collection efforts/calling for delinquent accounts receivables in accordance with State and Federal guidelines.
Prepares and posts adjustments as necessary.
Works daily/monthly reports which identify potential problems, including the daily Transaction Reply Report (TRR) from CMS and the daily/monthly compare files for Medicaid product lines.
Calculates 5500 Schedule A/C information for Medicare employer groups.
Responsible for maintaining professional relationships with customers/vendors; including resolving identified discrepancies in a timely manner
Responsible for ensuring timely and thorough eligibility and premium audit procedures are in place and being performed through direct performance. Ensures that department turnaround times and quality standards are met.
Responsible for preparing and communicating eligibility and premium decisions reviewed by the Eligibility Review Committee.

Qualifications:

Education:

Bachelor’s Degree preferred
A verifiable high school diploma or GED is required for all positions at Fallon Health and its affiliates, unless specified otherwise.

License/Certifications:

N/A

Experience:

4 plus years’ experience in an office environment, preferably in health care and/or managed care system
Strong analytical and problem-solving skills
Aptitude towards mathematical fundamentals
Flexibility in a fast-paced environment.
Excellent Organizational skills/time management
Strong focus on quality & performance results
Systems knowledge including but not limited to MS Excel, MS Word, MS Access.
Ability to effectively communicate, both written and verbal.
Builds Relationships/contributes to team performance
Adhere to all DOI, State, and Federal guidelines

Key Must Haves:

Excellent communication skills (oral and written)

Customer Service skills/experience-working with participants and peers

Computer skills-proficient to advanced typing skills and prior experience with Microsoft Office products

Key "Nice-to-Haves"

Prior experience working with Medicaid/Medicare

Pay Range Disclosure:
In accordance with the Massachusetts Wage Transparency Act, the pay for this position is $ 25.00 per hour which reflects what we reasonably and in good faith expect to pay at the time of posting. Final compensation will depend on the candidate’s experience, skills, and fit with the role’s responsibilities.

Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

#P01

Apply Now

Refine Your Search

jobs in woonsocket, ri

Eligibility & Revenue Operations Representative- Hybrid Schedule

Sales - Entry Level

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Member Services Representative Full and Part Time

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Distribution Tech - Purchasing and Stores

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Customer Service Associate I

Retail Store Associate

SALES ASSOCIATE

Retail Sales Associate Part Time

Member Services Full and Part Time Flexible Hours Fun Fast Paced Enviroment

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