Senior HCS Operations Inventory & Quality Analyst

Job not on LinkedIn

3 hours ago

Apply Now

Receive Emails with Similar Jobs

BASF

WebsiteLinkedInAll Job Openings

Chemicals • Agriculture • Healthcare

BASF is a global chemical company that operates across multiple sectors, providing a wide range of products and solutions. The company is focused on innovation and sustainability, serving industries such as agriculture, automotive, construction, electronics, energy, and healthcare. With a commitment to research and development, BASF aims to create chemicals that enhance the quality of life and support sustainable practices worldwide.

10,000+ employees

Founded 1865

🌾 Agriculture

📋 Description

• Work closely with the operations teams and data team to ensure inventory is accurately and efficiently distributed/assigned and transferred across teams based upon applicable inventory type workflow and requirements. • Conduct auditing of operations team activities on inventory to validate compliance with internal requirements, client contracts, regulatory requirements, and industry quality standards. • Facilitate communications and collaborate to convey/clarify requirements for inventory data flow based upon client/type/source serving as a liaison between the operations and eligibility & analytics data team. • Utilize SQL queries (and develop queries as may be needed) and leverage subject matter knowledge, independent judgement, and analytical skills to: Test data transfer/flow results. • Perform audit activity. • Create and maintain regular internal/external activity and metrics reporting; and Other support for operations workflow and activity. • Support payer outreach and EDI teams in the implementation of new EDI connections. • Conduct a variety of data analysis for intelligent insights using subject matter knowledge, independent judgement, and analytical expertise. • Mentors operations team and data team on paper and electronic claims processes Creates and maintains internal and external reporting as needed. • Contribute to development and continuous improvement of operational tools, processes and procedures for quality and inventory. • Provides Supervisors/Management with staff production quality results, as well as any insights for feedback/coaching/training opportunities based upon themes/trends identified to correct areas of quality deficiency and improve overall results. • May support management with developing or delivering training and tools for skills development to increase capability and effectiveness of analysts. • Operates under minimal supervision to deliver results aligned with business goals, given guidance in the form of high-level objectives. • Follows and complies with company, departmental and client program policies, processes, and procedures. • Responsible for utilizing resources to ensure compliance with client requirements, HIPAA, as well as applicable federal or state regulations. • Successfully completes, retains, applies, and adheres to content in required training as assigned. • Correct areas of deficiency and/or areas of opportunity for improvement received from management.

🎯 Requirements

• 5+ years of directly related progressive experience (claims, billing, eligibility, Medicaid/Medicare, etc.) • Bachelor’s degree in relevant field, or equivalent combination of education and experience • Minimum 1-year relevant experience demonstrating ability to work with large volumes of healthcare eligibility or client data, including data reporting, modeling, and analysis • Minimum 1 year of relevant experience in role(s) with responsibility for applying subject matter expertise to operations workflow, contributing to the set-up of new clients or programs, projects, quality/auditing, direct or indirect staff oversight or training, etc. • Knowledge and experience with rules around Medicaid / Medicare COB Other TPL business models and products • Skilled working with operations systems, tools, and applications for collecting and reporting data as well as identifying trends. • Demonstrated ability to work with large volumes of healthcare eligibility and claims data. • Intermediate skills in MS Excel required. • Utilization of SQL to run queries. Ability to develop basic queries a plus. • Strong general system and application skills with ability to quickly develop expertise in new systems and applications. • General knowledge of 270/271, 834, 277, 837, 835 highly desired • Familiarity with JIRA a plus • Professional verbal and written communication with good presentation skills • Ability to follow, document, and teach, as well as support improvement of, processes, procedures, and workflow. • Ability to work independently with minimal supervision • Strong analytical and problem-solving skills • Skilled at gathering, researching, interpreting, and documenting data and requirements for projects and/or complex problem solving. • Ability to produce results and maintain positive attitude in a dynamic environment.

🏖️ Benefits

• medical, dental, vision, HSA/FSA options • life insurance coverage • 401(k) savings plans • family/parental leave • paid holidays • paid time off annually