Job Summary

A health care provider is seeking a Remote Operations Excellence Analyst Associate.

Core Responsibilities of this position include:

• Reviewing insurance contracts to determine whether the Company's risks are assumed by the contract and evaluate the coverage opinions to determine agreement or disagreement with the insurance company's evaluation of coverage for claims
• Assisting and advising claims adjusters and corporate personnel on Risk Management interpretation of various claims
• Preparing monthly and quarterly status reports, as well as ad hoc loss runs and other claim data analyses from the TPA's system, company information and other sources

Qualifications Include:

• Bachelor's Degree and/or equivalent education or work experience
• 4 years operations health insurance and/or customer service experience required
• Skilled in reading and writing moderate to complex SQL commands and accurately assessing results (preferable 3+ years)
• Excellent documentation, organization, interpersonal, and written communication skills
• Competent in Microsoft Office; Excel, Word, Visio, PowerPoint