Operations Analyst – Medical Bill Review

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🕒 April 24

⚔️ 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 • 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

🎯 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 – 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

🏖️ Benefits

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