• Serve as a subject matter expert on vendor analytics (cost, quantity, services, contract (terms, timelines, deliverables) and performance (SLA & Penalties)) and retrospective and prospective target analytics for risk adjustment programs. • Perform vendor and risk analytic studies which involves manipulating large amounts of data. • Create retrospective and prospective target lists for risk adjustment programs. • Support EDGE supplemental submission. • Identify patterns and trends in diagnostic coding practices in conjunction with risk score measurement. • Provide complete and accurate information for vendor audits (costs) and government audits (CMS) related to Risk Adjustment. • Conduct ad-hoc analysis like gap and root cause. • Periodically update process flow charts for business stakeholders. • Identify problems within Enterprise Resource Planning (ERP) system such as reporting limitations and recommend solutions. • Research, analyze, validate, and prepare data across multiple system platforms and sources for use in monitoring and reporting. • Build reports for internal customers to track various risk adjustment activities and fulfill business needs.

• Responsible for determining the patient financial component for patient services. • Estimates, communicates and collects the patient financial responsibility and provides patient financial counseling. • Assists patients in understanding their insurance benefits including their co-payment, deductible and co-insurance responsibility. • Educates patient regarding financial assistance programs when appropriate. • Obtains patient demographic information and requests financial responsibility from the patient. • Determines patient qualification for coverage by third-party payer and informs financial counselor, patient or family member of status. • Verifies all commercial insurance coverage, workers compensation insurance, TPL insurance and state and government programs. • Documents and resolves patient concerns or inquiries that are received via telephone, mail or walk-in within an established time frame. • Validates Master Patient Index according to departmental policy. • Interprets physician orders. • Performs other duties as assigned.

• Commission-Only with uncapped earning potential • Average new agents earn $800–$1,200 per policy • Part-Time: $50K+ your first year • Full-Time: $80K–$300K+ your first year • Agency Owners: $200K–$500K+ annually in system-driven income

• Speak with clients over the phone or Zoom • Help families choose life insurance coverage that fits their needs • Work both warm inbound leads and Warm Lead leads - No Cold Calling • Track activity and stay consistent with daily production • Attend training and improve your sales skills