Operations Specialist II
Location
United States
Posted
5 days ago
Salary
$62.7K - $100.4K / year
Seniority
Mid Level
Job Description
Operations Specialist II
CareSource
• Provide analytical support and leadership for project impacting Claims and key internal Claims projects • Represent claims on cross-functional project work teams • Submit, monitor and prioritize IT tickets for the Claims department • Review special projects and identify issue trends and potential resolutions • Assist with Onbase reporting and processes • Develop and draft P&P’s and job aides for Claims • Assist in training claims staff on claims processing policy and procedures • Research and resolve provider claim issues and escalations by analyzing system configuration, payment policy, and claims data • Identify and quantify data issues within Claims and assist in the development of plans to resolve data issues
Job Requirements
- Bachelor’s degree or equivalent years of relevant work experience
- Minimum of two (2) years of healthcare claims environment is required
- Advanced level experience in Microsoft Word, Excel and PowerPoint
- Data analysis and trending skills
- Demonstrated understanding of claims operations specifically related to managed care
- Advanced knowledge of coding and billing processes, including CPT, ICD-9, ICD-10 and HCPCS coding
Benefits
- Comprehensive total rewards package
- Bonus tied to company and individual performance
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