Operations Analyst – Medical Bill Review

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🕒 Abril 24

⚔️ Virginia – Remoto

⚔️ Virginia – Remote

💵 $75.000 - $95.000 / ano

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

⚙️ Operações

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W. R. Berkley Corporation

SiteLinkedInTodas as Vagas

5001 - 10000 funcionários

Fundada em 1967

💸 Finanças

🤝 B2B

Insurance • Finance • B2B

A W. R. Berkley Corporation é uma empresa líder em seguros que opera através de mais de 55 negócios, fornecendo uma ampla gama de soluções de seguros para clientes comerciais e individuais de alto patrimônio. Com profunda expertise em várias indústrias, a Berkley se especializa na oferta de produtos de seguro personalizados que atendem a mercados de nicho. A empresa enfatiza sólidas parcerias com agentes e corretores para oferecer cobertura para riscos únicos e necessidades emergentes, garantindo proteção abrangente para seus clientes.

Descrição

• Serve as a subject-matter expert for Medical Bill Review (MBR) operations • Providing advanced production support, driving process improvements, and coordinating cross-functional issue resolution and project execution • Support the processing of workers’ compensation medical and pharmacy bills from bill intake through bill payment • Work directly with Berkley Operating Units to investigate bill processing issues • Responsible for problem-solving, identifying and triaging issues to technical teams • Interface with multiple vendors to facilitate issue resolution, issue documentation, tracking, and reporting • Independently and as part of a team identify issue commonalities and root causes to assist in solution design, monitoring, and controlling

🎯 Requisitos

• MBR business process SME including experience with MBR E2E process from a business/operations perspective • Firm understanding of integrated services and workflows including FS/UCR, Nurse and code review, PPO, negotiations, adjustor bill adjudication • Workers compensation regulatory environment experience/understanding • Demonstrated application of successful critical thinking and complex problem solving skills • Experience in a role requiring deep understanding of and experience working with MBR and integrated services technology – not at a developer level – but from a business analyst perspective • Experience gathering business requirements and clearly documenting complex scenarios and use cases to communicate MBR issues accurately for resolution • Communication experience with varied audiences including leadership and peers in business/operational & technology roles • Client-facing acumen • Team-player • Experience with Atlassian/JIRA/SQL

🏖️ Benefícios

• Health, Dental, Vision, Life, Disability • Wellness • Paid Time Off • 401(k) • Profit-Sharing plans