Hc And Insurance Operations Analyst

• In-depth knowledge and experience in the US healthcare (Non Voice) – Membership enrollment and billing
• Ability to train the team on new process and process updates
• Calibrate with QA’s to ensure process knowledge and variance are managed and under control
• Ability to create Process SOP, Process Map and identifying the outlier within process
• Review Discrepancy report and comments, identify gaps and share with TL
• Identify NVA and provide suggestion for automation opportunities
• Identify refresher/re-trainable topics, conduct assessments, and certify staff to move to different levels of production
• Drive team from the front in case of leadership unavailability
• Need to co-ordinate with quality team to identify the root cause and provide appropriate solution to overcome errors
• Oversee data integrity of member enrollment records and remittance files transmitted from the state
• Provide timely, efficient support for the eligibility load process while coordinating with corporate IS department to resolve issues that arise during the process
• Provide research to correct errors in membership and Primary Care Physician data output within the provider information system
• Research information on members/subscribers to resolve problems and disputes
• Maintains quality and production standards as outlined by government regulations and department policies & procedures
• Completion of volumes in queue within specified Turn Around Time
• Ability to meet their required production and Quality target
• Setting productivity /Quality benchmark
• Handles internal and external inquiries concerning billing, enrollment of member or subscriber

• Ability to work regularly scheduled shifts from Sunday - Saturday 5 PM IST time to 8 AM IST (5 days working)
• University degree or equivalent that required 3+ years of formal studies
• Work from Office
• No transport facility (Own transport)
• Ability to work in a team environment
• Good logical thinking ability
• Good English Comprehension/written skills should have exposure to MS Office
• Good Communication Skills – Both Verbal and Written
• Ability to interact with clients preferred

Ability to interact with clients preferred