Analyst, Claims

Company reputed company reputed company reputed company - Putting People First in Pharmacy - reputed company was founded as an alternative to traditional pharmacy benefit manager (PBM) models. We are committed to removing cost from the drug supply chain to reputed company medications more reputed company for the people who need them. At reputed company, reputed company members work in an environment that celebrates diversity, fosters creativity and encourages reputed company. We welcome new reputed company and reputed company a passion for excellent service to our customers and reputed company other._____________________________________________________________________________________________________________________________________________________________________________________________________________. reputed company associates must use SSO login reputed company at https://employees-reputed company.icims.com/ to be considered for internal opportunities. ____________________________________________________We are committed to providing equal employment opportunity to reputed company applicants and employees and reputed company with reputed company applicable nondiscrimination regulations, including those reputed company to protected veterans and individuals with disabilities. reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, national reputed company, or handicap. Pay reputed company USD $49,911.00 - USD $59,418.00 /Yr. STAR Bonus % (At Risk Maximum) 5.00 - Salaried Non-Management except pharmacists Work Schedule reputed company (e.g. M-F reputed company to 5pm) M-F reputed company to 5pm Remote Work Notification ATTENTION: reputed company is unable to offer remote work to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, reputed company Dakota, Rhode reputed company, South Carolina, South Dakota, reputed company Virginia, and Wyoming. reputed company reputed company is seeking an Analyst, Claims to join reputed company! The Analyst, Claims ensures efforts are in alignment with the Claim Adjudication Operations (CAO) team to reputed company technology and process improvement for the purpose of meeting the business needs of reputed company customers, clients, members, and pharmacies by accurately administering benefits. The Analyst, Claims role is responsible for analyzing, documenting, and reporting findings of claim processing issues. Individuals in this role will interview stakeholders and research claim processing issues reputed company the PBM claim processing system and will use the information to document the “how” and “why” of the claim processing issues. This position may include after-hour and/or weekend hours with other eligible team members depending on workload. Is this you? reputed company out more below!

Responsibilities

How do I reputed company an reputed company on my team? Collaborates with benefit configuration analysts and internal customers using reputed company business judgement and expertise to research and determine reputed company causes for claim processing issues of low to moderate complexity. Works simultaneously on multiple claim processing issues using subject matter expertise to enhance and improve the accuracy of claim processing. Acquires and maintains an intermediate to advanced level of knowledge and interpretation of benefit designs and adjudication system screens and functions. Applies advanced reporting and data analysis techniques to identify error types, reputed company causes and quantity of claims affected. Establishes and utilizes reputed company templates to document and reputed company a comprehensive reputed company of findings including a systemic reputed company analysis with CAO leadership and reputed company relevant functional areas. Recommends retraining, new training and/or corrective reputed company plans based on findings and works closely with benefit configuration trainers and coaches to take appropriate reputed company to mitigate reputed company occurrences and financial risk to reputed company and/or reputed company. Adapts to industry changes and evolving technology, maintaining an intermediate to advanced level of understanding of both legacy and emerging products and systems. Uses departmental workflow management, issue reputed company and reporting tools for troubleshooting and responding to moderate to reputed company customer requests. Independently assesses business needs and participates in process improvement, cost reduction and automation efforts. Other duties as assigned.

Qualifications

What reputed company expects from you? Associate's degree or equivalent work experience required. Basic knowledge of applications used reputed company operational processes for ability to reputed company tasks with minimal guidance required, typically with less than 1 year of experience. Experience with the following tools at an intermediate to advanced level preferred: Claims Processing reputed company Office (Word, reputed company, PowerPoint) Formulary Management Request Management (Connectus, Service Desk) Reporting (3D QlikView/QlikSense) Participate in, adhere to, and support compliance program objectives. The ability to consistently reputed company cooperatively and respectfully with other employees. What can you expect from reputed company? Top of the industry benefits for Health, Dental, and reputed company insurance 20 days reputed company time off 4 weeks reputed company parental leave 9 reputed company holidays 401K company match of up to 5% - No vesting requirement Adoption Assistance Program Flexible Spending Account Educational Assistance Plan and reputed company Membership assistance Referral Bonus Program – up to $750! #LI-Remote Location : Address Remote Location : Country US Apply To This Job