HC and Insurance Operations Analyst
Location
Tennessee | United States
Job description
In this Role you will be Responsible For
- Processing member enrollment and change forms, including data entry
- Verifying proper completion of enrollment and change documentation.
- Vast knowledge on Commercial group, Individual, Medicare and Qualified Health plans.
- Requesting and verifying information as needed to expedite enrollment.
- Ensuring accurate and timely completion of transactions for self and team to meet or exceed client SLAs.
- Processing daily enrollee invoices and premium reconciliation for members.
- Organizing and completing tasks per assigned priorities.
- Developing and maintaining a solid working knowledge of the healthcare insurance industry and of all products, services and processes performed by the team
- Resolving complex situations following pre-established guidelines
Requirements for this role include:
- University degree or equivalent that required formal studies of the English language and basic Math
- 5+ years of Enrollment and Premium Services experience that required to review enrollment rules and workflows.
- 5+ years of experience in the US Healthcare market that required a working knowledge of enrollment policies and procedures, exchange plans and Premium Reconciliation.
- 5+ years of experience that requires a k nowledge of healthcare insurance policy concepts including In Network, Out of Network providers, Deductible, Coinsurance, Co-pay, Out of Pocket, Maximum inside limits and Exclusions, State Variations.
**Required schedule availability for this position is Monday-Friday 6PM/4AM IST. The shift timings can be changed as per client requirements. Additionally, resources may have to do overtime and work on weekend’s basis business requirement.
Job tags
Salary
