Blue Cross of Idaho Supervisor EBS (Medicare Advantage Enrollment & Reimbursement) in Meridian, Idaho

To establish and supervise work procedures and training programs that are compliant with all applicable Federal and State regulations for Medicare Advantage (MA) enrollment processing and reimbursement reconciliation. Identify deficiencies in the department through development of performance and quality assurance programs, improving quality of data entry and Center for Medicaid/Medicare Services (CMS) acceptance rate. Develop compliant member written communications and make final decisions regarding eligibility, election period and enrollment-related grievances.

Required Experience:

  • Five years enrollment & billing experience within health insurance industry

Required Knowledge, Skills and Abilities (KSAs):**


  • Microsoft Word – Basic
  • Microsoft Excel – Basic
  • Written and verbal communication
  • Leadership

Ability to:

  • Assess regulatory guidance and translate into workflows, member communications and departmental business rules
  • Develop expertise in a variety of concepts, practices and procedures
  • Interpret large data sets for workflow and process deficiencies and take corrective action
  • Work independently and meet critical deadlines
  • Effectively monitor & maintain staff performance levels


  • Bachelor’s degree (preferably in business or health related field)
  • Supervisory experience
  • Experience in a Medicare Advantage program
  • Experience with Facets and with CMS systems including MARx, On Line Enrollment Center (OEC) and Health Plan Maintenance System (HPMS)
  • Knowledge of applicable CMS and State regulations and guidance manuals
  • Demonstrated performance and quality assurance monitoring

Salary: Grade 14 Internal Job Posting: 3/8/2018 - 3/16/2018 External Job Posting: 3/8/2018 - Until Filled

Job ID #: 1733

Location: Meridian, ID (Corporate Headquarters)

Job Category: Management

Education Required: Not Indicated

Employment Type: Full Time

Experience Required: 5 - 7 Years

Relocation Provided: No

Position Reports to: Director, Enrollment & Billing Services