HC & INSURANCE OPERATIONS ANALYST

Position General Duties:
Associate will process and update Provider Data Management and Provider Data Enrollment Resources to the Client’s main application according to its policies and procedures defined.
Role Responsibilities:
•    In-depth knowledge and experience in the US healthcare (Non Voice) – Provider Data Validation and Provider Data management.
•    Candidate should have 5 years and above experience in US healthcare and into provider enrollment and credentialling.
•    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 provider records and practitioner records that are loaded in the system.
•    Provide research to correct errors in Provider and Practitioner data output within the provider information system.
•    Maintain 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 provider forms, demographics, location details and practitioner records.

Required Skills:
•    3 to 5 years of experience in US healthcare working with Provider Data Enrollment and Management.
•    Ability to work in a 24/5 environment; shifts can be rotational.
•    University degree or equivalent that required 3+ years of formal studies.
•    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.

  **Required schedule availability for this position is 24/5 and the shift timings can be changed as per client requirements. Additionally, resources may have to do overtime and work on weekend’s basis business requirement.