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Standard job listing
Title of job: Membership Specialist
Job Location: Wilmington, Delaware, 19803
Job Type: Contract to Hire
Price Range:
Negotiable, Depending on experience
Start Date:
ASAP
End Date:
Not a pressing concern
Categories:
# Section Category Subcategory
#1 Health Care Health Care Administration
Qualifications:
See above

Other desired skills:
Membership Specialist
Job/Project Details: Categories: Healthcare Administration, PharmaceuticalA Membership Specialist is responsible for ensuring contracted customers are appropriately classified into industry market segments and made eligible for managed markets contracts. Incumbent also works as part of a cross-functional team to resolve claim/payment errors, and maintains internal/external customer relationships to assist in this resolution process. Requirements:Critical components of the Membership Specialist role: Manage, analyze, research, process and maintain membership, dedication, and applicable contract eligibility for managed markets customers. Completely investigate prospective new contracted customers and provide direction to Database Specialists regarding customer creation/set-up. This includes determining the appropriate trade class/market segment as well as ensuring all pertinent customer data is captured for customer setup. Communicate with internal and external customers to clarify contract requirements with regard to appropriate contract eligibility and pricing in order to reconcile current and reduce future discrepancies. Appropriately administer contracting strategies as they relate to membership and communicate applicable pricing to wholesalers and customers as needed. Participate in the error and payment resolution processes. Participate on cross-functional teams lending support and input from a membership perspective. Meet all compliance-related requirements such as completion of mandatory training, adherence to audit controls and SOX requirements, and adherence to all company policies, procedures, and SOPs.df-jb

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