Operations Specialist, Senior (Part-Time)

Your Role

This is a part-time position supporting the Post Service Review team reviews claims for benefits, medical necessity, coding accuracy and medical policy compliance. The Operations Specialist, Senior will report to the Senior Manager, Post Service Team. In this role you will be responsible for problem solving issues, testing, training and updating documentation as needed. You will work to enhance the department's operations with efficiency and attention to detail/quality.

Qualifications

Your Knowledge and Experience

• Requires a college degree or equivalent experience and minimum 5 years of prior relevant experience(e.g., claims, customer service)
• Excellent analytical and problem-solving skills.
• Strong skills in standard Microsoft Office applications (e.g., Excel, Word, Outlook, Access).
• Strong coordination and interpersonal skills working in a matrixed environment with multiple stakeholders.
• Ability to identify and resolve complex problems related to automated systems and operations within functional area.
• Broad knowledge of technical and operational practices in the claim's processing system is preferred.