A well-known insurance company has a current position open for a Telecommute Entry Level Workers Compensation Associate Claim Representative. Core Responsibilities Include: Performing initial file intake, project and execute accurate and timely payments.
Advanced knowledge of Microsoft Office tools to include Word, Excel and Powerpoint. Advanced knowledge of data analysis tools and techniques. Advanced knowledge of regulatory compliance.
Proven ability to deliver results in a demanding and fast-paced environment. Ability to communicate with stakeholders from all levels to convey complex data in tangible business terms. Microsoft Office skills, such as Excel, PowerPoint and Microsoft Word.
Create and update automated processes within client databases. Interpret and analyze claims, premium, capitation and membership data. Qualifications for this position include: At least a beginner level proficiency with SQL, SAS and/or other statistical programs.
Participating in the design, development, implementation and monitoring of quality programs. Useing pertinent data and facts to identify and solve a range of problems within area of expertise. Working with a team to provide end to end continuous quality improvement. Required Skills:
Microsoft Project, Sharepoint, Webex, OMMs, project charters and project strategy. Basic technology knowledge, data management and analysis experience as well as Business Requirement Document and procurement routines.
An insurance company is in need of a Telecommute Data Analysis Consultant in Hartford. Candidates will be responsible for the following: Defining, identifying, and creating data responsive to regulatory requirements. Capturing, analyzing and interpreting claims data.
Candidates will be responsible for the following: Utilizing information from claims data analysis, plan members, employees conduct confidential investigations and document relevant findings. Investigating and resolving instances of healthcare fraud and / or abusive conduct.
Performing comprehensive data reviews and participating in investigative interviews. Being accountable for assigned risk adjustment investigations. Skills and Requirements Include: Travel 25 % of the Time. Prior healthcare fraud investigations experience.