Operations Specialist II (TriZetto Facets) - Remote

Overview

The Operations Specialist II provides analytical support and leadership for project impacting Claims and key internal Claims projects.

In Short

• Represent claims on cross-functional project work teams
• Submit, monitor and prioritize IT tickets for the Claims department
• Review special projects and identify issue trends and potential resolutions
• Assist with Onbase reporting and processes
• Develop and draft P&P’s and job aides for Claims
• Assist in training claims staff on claims processing policy and procedures
• Research and resolve provider claim issues and escalations
• Perform analysis of all claims data
• Identify and quantify data issues within Claims
• Provide input for claims business requirements and testing processes

Requirements

• Bachelor’s degree or equivalent work experience required
• Minimum of two years of healthcare claims processing experience required
• TriZetto Facets claims experience highly preferred
• Claims automation/scripting experience highly preferred
• Advanced level experience in Microsoft Word, Excel, and PowerPoint
• Data analysis and trending skills
• Understanding of claims operations related to managed care
• Knowledge of coding and billing processes
• Strong interpersonal and communication skills
• Attention to detail and time management skills

Benefits

• Comprehensive total rewards package
• Bonus tied to company and individual performance
• Inclusive environment that welcomes individuals of all backgrounds
• Support for personal and professional development
• Opportunity to make a difference in the community