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strong BA candidates that have obvsiouly worked in the healthcare industry THEY HAVE HAD TO WORK WITH ACA (AFFORDABLE CARE ACT) AND HIX (HEALTH INSURANCE EXCHANGE) IF YOU SEND A BA WITHOUT THESE HE/SHE WILL NOT BE CONSIDERED
To assist in the development, coordination, implementation and monitoring of Affordable Care Act (ACA) and Health Insurance Exchange ( HIX) activities related to Provider and community relationships. Ensuring that regulations, policies and objectives are fully supported by the Customer Service contractor and that the contractor communicates those regulations, policies and objectives accurately .
Support the development and implementation of Affordable Care Act (ACA) and Health Insurance Exchange (HIX).
Lead, facilitate and support workgroups to address all ACA provisions that impact provider (i.e. provider screening and enrollment requirements revalidation, provider disclosures, overpayments, NCCI, etc.).
Collaborate with Business Analyst (BAs) to evaluate all business needs, define system impact, document changes, and Co- sponsor all enhancements.
Develop and implement standards to monitored and evaluate the customer service contractor’s compliance with ACA and HIX provisions.
Participate in the review and editing of the Customer Service contractor’s policy and procedures to ensure appropriate adoption and support of ACA and HIX provisions.
Update and maintain Customer Relation’s Internal Controls document consistent with ACA and HIX provisions.
Serve as a Liaison between the customer service contractor, member services and customer relations staff to coordinate and address issues and escalations.
Serve as a key contact for staff, Providers and other external stakeholders by providing information on the ongoing implementation, evaluation and monitoring activities
Support the development, validation an ongoing monitoring of reports required to support ACA and HIX activities.
Assist the customer service contractor with developing, editing, and maintaining material to be posted
Support the weekly review and editing of provider remit messages, all training material and provider correspondence.
Participate in educational and informational forums (i.e. provider trainings, Provider Association sponsored events or workgroups, staff meetings, etc.).