Functional Analyst I

Operations Support Specialist

Provides Operations Support by obtaining facts; analyzing enrollment related problems; designing solutions; developing testing methods; conducting and documenting tests; providing operating information to customers.

Essential Functions:

• 50% Research and improve operations by examining and researching systems problems by obtaining facts, analyzing problems/identifying root cause recommending and facilitating resolution.
• 20% Supports operations systems by providing operating EDI enrollment information to customers; answering questions; providing training.
• 20% Contributes to operations analysis and organization success by welcoming related, different, and new requests; helping others accomplish job results, development of Standard Operating Procedures (SOP) and other essential documentation
• 5% Verifies operations systems by developing testing methods, conducting, and documenting tests.
• 5% Improves operations analysis job knowledge by attending training sessions, reading technical publications.

Qualifications:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Experience working in claims, triage, or enrollment EDI

Education Level: Bachelor's Degree

Education Details: Business Administration

Experience: 2 years’ experience in (level 2 or above) operational role.

In Lieu of Education

In lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience.

Preferred Qualifications:

Knowledge, Skills, and Abilities (KSAs)

Ability to recognize, analyze, and solve a variety of problems., Proficient

Highly proficient in Microsoft Office and similar applications., Proficient

Organized, detail-oriented while meeting strict deadlines., Proficient

Excellent communication skills both written and verbal., Proficient

Demonstrate ability to work independently, Proficient

The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes them ineligible to perform work directly or indirectly on Federal health care programs. Must be able to effectively work in a fast-paced environment with frequently changing priorities, deadlines, and workloads that can be variable for long periods of time. Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence. Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.

***This role is 100% Remote to U.S.