Workers Compensation, Medical Bill Review, Operations Analyst

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🕒 Abril 28

⚔️ 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; • Provide advanced production support and drive process improvements; • Coordinate cross-functional issue resolution and project execution; • Support processing of workers’ compensation medical and pharmacy bills from bill intake through payment; • Investigate bill processing issues and problem-solve; • Interface with multiple vendors for issue resolution; • Monitor business dashboards and vendor reports daily for TAT trends; • Recommend workflow enhancements and document trends and issues for improvement; • Build and maintain relationships with internal teams, external vendors, and medical providers.

🎯 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; • Experience gathering business requirements and clearly documenting complex scenarios and use cases; • Communication experience with varied audiences including leadership and peers in business/operational & technology roles; • Client-facing acumen; • Team-player; • Experience with Atlassian/JIRA/SQL. • 5 years in a multi-faceted workers compensation MBR role demonstrating increasing responsibility with required skills outlined above within that time or 3 years in an MBR role + 2 years in position with similar responsibilities.

🏖️ Benefícios

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