Operations Analyst Commercial - FCC
Company: Carle Health
Location: Pinehurst
Posted on: January 26, 2023
|
|
Job Description:
Position Summary:
The Operations Analyst position performs several key operational
duties such as reviewing and researching claims, performing
enrollment functions, interacting with customers via phone, email,
and in person meetings and also is responsible for auditing
delegated services with our partner vendors. The position also
performs other support functions requiring the use of copiers,
scanners, faxing, and mailing items. The position audits claim
payments, tests benefit plans, reprices claims, and updates
policies and procedures to ensure compliance is met.
Qualifications:
EDUCATIONAL REQUIREMENTS
Bachelor's Degree in Business, Management, or a related area.
Significant experience may be accepted in lieu of formal
education.
CERTIFICATION & LICENSURE REQUIREMENTS
None specified
EXPERIENCE REQUIREMENTS
Five years experience in claims processing, benefit building,
healthcare billing, managed care contracting, and/or patient
accounting. Two years experience in customer service and/or
provider service. One year experience in auditing and/or
training.
OTHER REQUIREMENTS
Office automation/personal computer skills with excellent knowledge
level in Excel, Word, and Microsoft Access. Requires strong verbal
and written communication skills, conflict resolution and
negotiation skills, and ability to provide strong attention to
detail. Advanced knowledge of CPT coding, ICD-9 coding, and medical
terminology.
Essential Functions:
We are an Equal Opportunity Employer and do not discriminate
against any employee or applicant for employment because of race,
color, sex, age, national origin, religion, sexual orientation,
gender identity, status as a veteran, and basis of disability or
any other federal, state or local protected class. Carle Health
participates in E-Verify and may provide the Social Security
Administration and, if necessary, the Department of Homeland
Security with information from each new employee's Form I-9 to
confirm work authorization. - For more information:
human.resources@carle.com.
Effective September 20, 2021, the COVID 19 vaccine is required for
all new Carle Health team members. Requests for medical or
religious exemption will be permitted.
Keywords: Carle Health, Fayetteville , Operations Analyst Commercial - FCC, Professions , Pinehurst, North Carolina
Click
here to apply!
|