Claims Analyst

Job Description

Job Title – Data Analyst

Work hours: 9am-5pm

Start date: Immediately

Location Address: Mason, OH

FACETS experience is preferred but not mandatory

GENERAL FUNCTION

Serve as a Data Analyst on the Business Configuration team, responsible for the structure, and benefit plan set up for client's Managed Vision Care clients. Provide subject matter expertise for product configuration in the Facets system. Partner with client cross functional teams to ensure efficiency and accuracy of configuration requests.

MAJOR DUTIES AND RESPONSIBILITIES

• Responsible for configuring all types of managed vision care products in the system (using both the Product Key Sheet method and manual configuration)

• Responsible for product configuration accuracy utilizing the configuration tools for manual and automated product creation.

• Write SQL queries and export from database to analyze and troubleshoot configuration issues, as well as perform issue resolution of requests.

• Perform and resolve product configuration questions/issues sent to the Business Configuration production team without guidance.

• Maintain relationships with Implementation Managers, Account Managers, and develop a cohesive cross functional, results driven working environment.

• Self-manage completion of work inventory in the production queues within established quality and turnaround time service levels.

• Coordinate and participate in cross-functional team activities for issue resolution

• Recommend process and system enhancements to drive improvements.

• Support the management team with on-going training activities, misc. projects, resolving issues, and serving as a subject matter expert for all Configuration requests.

BASIC QUALIFICATIONS

• Associate degree or equivalent experience required.

• At least 5 years of experience working within a core claims administration system.

• Good analytical and problem-solving skills

• A minimum of 2 years' experience writing SQL queries and exporting data from database tables into Excel for analysis.

• Good communication and interpersonal skills

• Ability to work independently or as a part of a team.

• Ability to manage multiple complex assignments at once.

PREFERRED QUALIFICATIONS

• 3+ years' experience in Operations in the Healthcare industry

• Experience understanding claim adjudication for member and provider reimbursements.

• Experience with Facets platform using Claims, Provider, Network, Product Benefit Configuration

• Knowledge of Medicare and Medicaid programs

Thanks & Best Regards,

Praveen Sakibanda

Sr Talent Acquisition Specialist

View email address on ziprecruiter.com

View phone number on ziprecruiter.com

Diversity Nexus

4365 Route 1 South Princeton NJ, 08540

Praveen Sakibanda| LinkedIn