Tampa, Florida, USA
10 days ago
ACA Reconciliation Coordinator
Here we grow again! Wipro is seeking individuals who combine excellent customer service and problem-solving skills with the ability to function effectively both as part of a team or on an individual basis to bring their talent to our team. Wipro is a leading global IT solutions and services company with over 200,000 dedicated employees serving clients across more than 66 countries. We offer a strong compensation package that includes competitive pay and day one benefits. Wipro also offers many opportunities for career advancement within our engaging and exciting culture. 100% remote (Note – If you reside in the Tampa area this role is hybrid) Work authorization: USC and Green Card only No relocation ACA Reconciliation Coordinator We are seeking a skilled Reconciliation Lead with extensive knowledge in the Affordable Care Act (ACA) reconciliation processes. The ideal candidate will have a deep understanding of the ACA reconciliation lifecycle, including Pre-Audit, RCNI, RCNO, and ER&R submissions. This role involves overseeing activities related to reconciliation initiatives, coordinating between teams, and ensuring compliance with ACA regulations. This role would be the point person that would coordinate timely reports and would be familiar with the activities of the recon team and client requirements. Key Responsibilities: Project Management: Lead and coordinate ACA reconciliation projects from initiation to completion within recon operations. Develop detailed project plans, including timelines, milestones, and deliverables. Coordinate with internal teams, stakeholders, and external partners to ensure project goals are met. Monitor initiatives/projects and make adjustments as necessary to ensure successful project delivery. ACA Reconciliation Process Knowledge: Understand and oversee the Pre-Audit process, ensuring the accuracy and completeness of enrollment data extracted from the FFM (Federally Facilitated Marketplace). Familiar with RCNI (Inbound Enrollment Reconciliation) submissions, ensuring correct data format and content. Review and interpret RCNO (Outbound Enrollment Reconciliation) files to identify and resolve discrepancies between issuer and FFM records. Manage ERR (Enrollment Reconciliation & Resolution) submissions for handling unresolved discrepancies. Compliance and Reporting: Ensure all ACA reconciliation activities comply with CMS guidelines and timelines. Generate regular status reports for senior management, detailing project progress, issues, and risk mitigation strategies. Maintain comprehensive documentation of reconciliation processes and outcomes. Stakeholder Communication: Serve as the primary point of contact for all ACA reconciliation-related inquiries. Facilitate communication between CMS, issuers, and internal teams to address and resolve any issues promptly. Conduct training sessions and provide guidance to team members on ACA reconciliation processes and best practices. Qualifications: Education and Experience: Bachelor’s degree in Business Administration, Healthcare Management, or a related field. Minimum of 5 years of experience in ACA reconciliations/processing in healthcare or insurance sectors. Proven experience with ACA reconciliation processes and CMS guidelines. Skills and Competencies: Strong knowledge of the ACA reconciliation lifecycle, including Pre-Audit, RCNI, RCNO, and ER&R processes. Excellent coordination skills with the ability to manage multiple initiatives/projects simultaneously. Proficiency in data analysis and interpretation. Strong communication and interpersonal skills to effectively interact with stakeholders at all levels. Detail-oriented with exceptional organizational and documentation skills. Proficiency with project coordination/management tools and software.
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