Buy-In Clerk

Summary

As a Buy In Clerk at Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve — a community’s most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare’s biggest challenges. Here are the details on this position.

Your role in our mission

• Data Entry of buy-in accretions, deletions, and change transactions
• Buy-in clerk will utilize various data from various systems to update FMMIS panels to ensure Buy-In coverage is stopped or started as applicable
• Maintenance of entitlement periods, via corrections to Medicare numbers and Medicare Part A and Part B entitlement spans, as necessary.
• Notification to the Department of Children and Families (DCF) of demographic and Medicare changes needed to Florida online recipient Integrated Data Access (FLORIDA) records
• Creation of emails to the Centers for Medicare and Medicaid Services (CMS) for assistance, when needed, with accretions, deletions, and reimbursement of premiums billed to the State in error by CMS.
• Buy-In clerk validates, processes, or returns to sender (RTS) of Buy-in inquiry request forms as applicable
• Communicates with the Social Security Administration (SSA) for corrections to the Master Beneficiary Record (MBR).
• Knowledge of FL/State Data Exchange System (SDX) FLMMIS update processes for Medicaid eligibility and Medicare information, including understanding of the hierarchy for Buy-In Eligibility Codes (BIEC), aid categories, as well as the hierarchy for SDX, FLORIDA (FL), BENDEX, EDB and online changes.
• Read and understand all Buy-In related manuals.
• Understanding of all different reports for Buy-In department and able to assist as a Quality Control reviewer for all Buy-In inquiries processed by Buy-In clerks.  
• Understanding of the Buy-In SLA’s time frames, and able to manage/make corrections for Quality Control reviews prior to SLA’s deadline.  
• Consistently meet/ exceed all deliverables and contracted SLA requirements
• Must attend ongoing training sessions and meetings for Buy-In

What we're looking for

• • Attention to detail and accuracy will be the key factor
  • Excellent attendance is required
  • Must be Microsoft suite proficient especially Excel
  • Excellent verbal and written communication skills
  • Ability to keep a positive attitude, time management and problem solver
  • Operational discipline, Professionalism, and ability to remain calm under pressure

What you should expect in this role

• Bachelor’s degree or equivalent experience
• Experience with MMIS, CMS, DCF is preferred

• Full time Position/8 am to 5 pm (Mon – Fri) and flexible with working on site as required

No Time off for initial training period (120 days

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