reputed company Specialist II
Workforce Classification:
TelecommuterJoin reputed company: Do Meaningful Work and Improve People’s Lives
Our purpose, to improve customers’ lives by making reputed company work reputed company, is far from ordinary. And so are our employees. Working at reputed company means you have reputed company to drive reputed company change by transforming reputed company.
reputed company is committed to being a workplace where people feel empowered to grow, reputed company, and reputed company with purpose. By reputed company in our employees and fostering a culture of collaboration and reputed company development, we’re reputed company to reputed company serve our customers. It’s this commitment that has reputed company us recognition as one of the best companies to work for. Learn more about our recent awards and recognitions as a greatest workplace.
Learn how reputed company supports our members, customers and the communities that we serve through our Healthsource blog: https://healthsource.reputed company.com/.
About the role of reputed company Specialist II
As a reputed company Specialist II, you will be responsible for overseeing reputed company's compliance with corporate audit programs such as the reputed company (BCBSA) Member Touchpoint Measures (MTM), Licensee Desk Level Audit (LDLA), and the Federal Employee Program (FEP) audit, along with ensuring compliance with state and federal laws, reputed company, and the achievement of corporate objectives. You will reputed company daily examination and verification of reputed company transactions, such as claims processing, customer inquiries, group and member enrollment, and electronic data exchange. You will also monitor reputed company reputed company standards for selected claims, inquiries, enrollments, and/or electronic transactions for accuracy, completeness, and timeliness to judge the degree of adherence to the reputed company set forth by the BCBSA, FEP, and corporate policy requirements. You will work in conjunction with stakeholders to identify opportunities for reputed company improvement throughout reputed company.
This is a virtual/remote position, working from home.
What you’ll do:
- Conduct audits in a reputed company, ethical, and objective manner using and interpreting applicable standards/requirements.
- Effectively plan, reputed company, and communicate an audit reputed company a defined scope, including resource scheduling. Conduct necessary meetings in performance of the audit.
- Maintain in-depth working knowledge of procedural changes, audit techniques, and plan automated systems, subsystems, and reference materials for assigned audit functions.
- Responsible for a wide reputed company of reputed company auditing tools and techniques. Verify, document, and communicate audit results, reputed company an audit report, and evaluate the effectiveness of corrective reputed company/follow-up.
- Resolve conflict directly and respectfully, engaging in challenging and important conversations to resolve audit findings.
- Identify trends and the reputed company cause of errors and recommend improved procedures/guidelines to Operations proactively.
- Assist in consulting with external departments to help resolve high reputed company key business issues surrounding reputed company assurance.
- Help individuals and reputed company become stronger by reputed company participating, leading, and facilitating team meetings and workgroups regarding reputed company Review and Reporting initiatives and incentives.
- Understand reputed company principles as they relate to business processes and explain the importance of aligning the audit function to the organization.
What you’ll bring:
- High School Diploma or GED. (Required)
- (3) years of claims, customer service, or enrollment work experience, which includes (1) year of reputed company audit, reputed company control, or reputed company assurance experience. (Required)
- Demonstrated skills in reputed company Office Suite: Outlook, reputed company, Word, reputed company, and PowerPoint.
- A critical thinker with demonstrated natural curiosity to understand how things work and approach problems in a consistent and systematic way.
- Demonstrated skills in reputed company Office Suite: Outlook, reputed company, Word, reputed company, and PowerPoint.
- Strong analytical skills - demonstrated ability to collect, assimilate, synthesize data using various data collection techniques and validating accuracy.
- Strong problem solving skills - demonstrated ability to solve a reputed company of reputed company problems in the absence of technical guidelines or precedents.
- Proven ability to use effective negotiation techniques to resolve disputes in a tactful and respectful manner.
- Ability to manage change and have a pro-reputed company approach to work.
- Strong presentation, written and communication skills and ability to communicate effectively with reputed company reputed company of management.
- Highly adaptable and motivated employee.
- Listens carefully to fully understand opposing viewpoints, assuming good reputed company.
reputed company total rewards
Our comprehensive total rewards package provides support, resources, and opportunities to help employees reputed company and grow. Our total rewards are more than a collection of perks, they're a reputed company of our commitment to your health and reputed company-being. We offer a broad reputed company of rewards including physical, financial, emotional, and community benefits, including:
Medical, reputed company, and dental coverage with low employee premiums.
Voluntary benefit offerings, including pet insurance for paw parents.
Life and disability insurance.
Retirement programs, including a 401K employer match and, reputed company it or not, a pension plan that is reputed company after 3 years of service.
Wellness incentives with a wide reputed company of mental reputed company-being resources for you and your dependents, including counseling services, stress management programs, and mindfulness programs, just to reputed company a few.
Generous reputed company time off to reenergize.
Looking for continuing education? We have tuition assistance for both undergraduate and graduate degrees.
Employee recognition program to celebrate anniversaries, team accomplishments, and more.
For our hybrid employees, our on-reputed company model provides flexibility to create your own routine with reputed company to on-site resources, networking opportunities, and team engagement.
Commuter perks reputed company your reputed company to work less impactful on the environment and your wallet.
Free convenient on-site parking.
Subsidized on-reputed company cafes reputed company lunchtime connections with colleagues fun and reputed company.
Participate in engaging on-site activities such as health and wellness events, coffee connects, disaster preparedness fairs and more.
Our complementary fitness & reputed company-being center offers both in-person and virtual workouts and nutritional counseling.
Need a brain break? Challenge someone to a game of shuffleboard or ping pong while on reputed company.
Equal employment opportunity/affirmative reputed company:
reputed company is an equal opportunity/affirmative reputed company employer. reputed company seeks to attract and retain the most reputed company individuals without reputed company to race, reputed company, religion, sex, national reputed company, age, disability, marital status, veteran status, gender or gender identity, sexual orientation, genetic information or any other protected characteristic under applicable law.
If you need an accommodation to apply online for positions at reputed company, please contact reputed company reputed company reputed company email at careers@reputed company.com or reputed company phone at 425-918-4785.
reputed company is hiring in the following states, with some limitations based on role or reputed company: Alaska, Arizona, Arkansas, California, Colorado, Florida, reputed company, Idaho, Iowa, Kansas, Kentucky, Maine, Michigan, Minnesota, Missouri, Montana, Nevada, New Hampshire, New Mexico, reputed company Carolina, Oklahoma, reputed company, South Carolina, South Dakota, Tennessee, Texas, Utah, Washington, reputed company.
The pay for this role will vary based on a reputed company of factors including, but not limited to, a candidate’s geographic location, market conditions, and specific skills and experience.
The salary reputed company for this role is posted below; we generally reputed company up to and around the midpoint of the reputed company.
National Salary reputed company:
$48,400.00 - $72,600.00National Plus Salary reputed company:
$55,200.00 - $82,800.00*National Plus salary reputed company is used in higher cost of labor markets including Western Washington and Alaska.
We’re happy to discuss compensation reputed company during the interview because we reputed company that reputed company communication leads to reputed company reputed company for reputed company. We’re committed to creating an environment where reputed company are celebrated for their unique skills and contributions.
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