Workers Compensation, Medical Bill Review, Operations Analyst

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🕒 April 28

⚔️ Virginia – Remote

⚔️ Virginia – Remote

💵 $75k - $95k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

⚙️ Operations

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W. R. Berkley Corporation

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

Founded 1967

💸 Finance

🤝 B2B

Insurance • Finance • B2B

W. R. Berkley Corporation is a leading insurance company that operates through over 55 businesses, providing a wide range of insurance solutions for both commercial and high-net-worth individual clients. With deep expertise in various industries, Berkley specializes in offering tailored insurance products that cater to niche markets. The company emphasizes strong partnerships with agents and brokers to deliver coverage for unique risks and emerging needs, ensuring comprehensive protection for its customers.

📋 Description

• 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.

🎯 Requirements

• 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.

🏖️ Benefits

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