Medicare Advantage Premium Billing Analyst

Ampcus Inc. is a certified global provider of a broad range of Technology and Business consulting services. We are in search of a highly motivated candidate to join our talented Team.

Job Title: Medicare Advantage Premium Billing Analyst

Location(s): Los Angeles, CA

(Remote)

Position Summary
We are seeking a Medicare Advantage Premium Billing Analyst with 3-5 years of hands-on experience supporting Medicare Advantage Prescription Drug Plans (MAPD). The ideal candidate will have strong knowledge of Medicare enrollment, billing, reconciliation, and CMS requirements, along with experience working with State and CMS files.

This position will support premium billing and enrollment operations, investigate payment discrepancies, resolve member inquiries, and perform reconciliation activities while ensuring compliance with applicable Medicare and regulatory requirements.

Key Responsibilities

• Analyze and resolve premium billing and payment discrepancies.
• Perform enrollment, disenrollment, and reconciliation activities.
• Investigate and resolve member billing and enrollment inquiries.
• Review and process State and CMS files.
• Support Medicare membership enrollment operations.
• Perform billing and enrollment reconciliations and identify variances.
• Research discrepancies and coordinate appropriate resolution.
• Apply basic principles of finance, accounting, bookkeeping, and billing procedures.
• Maintain accurate records and documentation related to billing and reconciliation activities.
• Ensure work is performed in accordance with Medicare, CMS, and applicable regulatory requirements.
• Collaborate with internal teams to resolve enrollment and billing issues.

Required Qualifications

• High School Diploma or equivalent.
• 3-5 years of experience working in a Medicare health plan or Managed Care environment.
• 3-5 years of experience specifically supporting Medicare Advantage Prescription Drug Plans (MAPD).
• Experience with Medicare enrollment, disenrollment, and reconciliation.
• Strong knowledge of Medicare and CMS enrollment and billing regulatory requirements.
• Experience working with State and CMS files.
• Working knowledge of finance, accounting, bookkeeping, and billing principles.
• Strong analytical, problem-solving, and reconciliation skills.
• Excellent attention to detail and ability to investigate discrepancies effectively.
• Strong written and verbal communication skills.

Schedule:

• Monday-Friday, 08:00 AM - 05:00 PM.

Ampcus is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veterans or individuals with disabilities.