At Rochester Regional Health, the health and safety of our employees and candidates is very important to us. Due to the current situation related to the Coronavirus (COVID-19), we’re leveraging our digital capabilities to ensure we can continue to recruit top talent.

As your application progresses, you may be asked to use one of our digital tools to help you through your recruitment journey. One of our Talent Acquisition colleagues will guide you throughout the interview process and will be on hand to answer any questions you might have.

Due to the COVID-19 situation, we have immediate per diem positions available across our system. Join Our Team at the forefront of patient care.

Skip Navigation

Healthcare Enrollment Validation Specialist - Cognisight

Apply Now
Job ID REQ_110884 FACILITY Various Locations LOCATION Rochester, New York

Job Title:Department:

Healthcare Enrollment Validation Specialist                                                    Medical Record Department


Full Time (Monday-Friday)

Business Hours with Flexibility

Report To:

Senior Mgr., Client Operations

Job Description:

Provide overall audit support with duties that include, but are not limited to:

  • Proficiency in health plan Demographic and Enrollment and RXC systems and workflows
  • Ability to work in a fast paced, complex organization, with regulated deadlines while providing effective audit support to multiple clients.
  • Develops and maintains excellent relationships; internally within team setting and externally, across large client base.
  • Accountable for performing critical Demographic and Enrollment and RXC audit function with strong attention to detail and 100% accuracy, while navigating multiple client Enrollment and RXC source systems.
  • Creates and maintains documentation in support of CMS mandated audit of health insurance plans’ demographic and claims information.
  • Obtains relevant information towards finalizing deliverables based on client input and requirements from CMS documentation.
  • Own client audit status’ and provide accurate updates, gap discovery and closure planning to Account Management and client
  • Creates, delivers client presentations relative to Demographic and Enrollment and RXC Data Validation Audit regulations, guidelines and client results.
  • Staying apprised of the Department of Health and Human Services (HHS) regulations and guidelines relative to Demographic and Enrollment and RXC Data Validation Audits.


  • Bachelor’s degree preferred with Healthcare/Health Plan or Medicare/ACA background required
  • Minimum of 3 years’ experience in a healthcare, health insurance, enrollment/claims processing; with proficient knowledge of Risk Adjustment and government audits as demonstrated with health plans
  • High level of professionalism
  • Must be self-directed and escalate concerns with potential solutions
  • Proficiency in Microsoft Office Suite and proprietary software tools
  • Strong written and verbal communication internally and client facing
  • Excellent organizational skills and priority setting for self, team, and client(s)
  • Ability to present to clients
  • Minimal US based travel – not to exceed 10%

Additional Requirements:

  • New York State Driver’s License
  • Independent means of transportation
  • Physical ability to travel if necessary

    Please forward resumes to

    Thank you.

Rochester Regional Health is an Equal Opportunity / Affirmative Action Employer. Minority/Female/Disability/Veteran
Apply Now

Sign Up For Job

Stay connected and receive the latest news, events and career opportunities at Rochester Regional Health.

Interested InSelect locations and/or categories of interest below and click "Add"

  • Information Technology, Rochester, New York, United StatesRemove

By uploading your resume, you are not submitting an application for employment.

* Required Field