HCS Operations Inventory & Quality Analyst – Eligibility
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Job Description
HCS Operations Inventory & Quality Analyst leveraging healthcare eligibility and data analysis skills. Ensuring effective inventory management and compliance across operations teams in a remote role.
Responsibilities:
- Work closely with the operations teams and data team to ensure inventory is accurately and efficiently distributed/assigned and transferred across teams based upon applicable inventory type workflow and requirements.
- Conduct auditing of operations team activities on inventory to validate compliance with internal requirements, client contracts, regulatory requirements, and industry quality standards.
- Facilitate communications and collaborate to convey/clarify requirements for inventory data flow based upon client/type/source serving as a liaison between the operations and eligibility & analytics data team.
- Utilize SQL queries (and develop queries as may be needed) and leverage subject matter knowledge, independent judgement, and analytical skills to: Test data transfer/flow results.
- Perform audit activity. Create and maintain regular internal/external activity and metrics reporting; and Other support for operations workflow and activity. Mentors operations team and data team on paper and electronic claims processes
Requirements:
- Bachelor’s degree in relevant field, or equivalent combination of education and experience
- At least three (3) years of directly related progressive experience (claims, billing, eligibility, Medicaid/Medicare, etc.)
- Minimum two (2) years relevant experience demonstrating ability to work with large volumes of healthcare eligibility or client data, including data reporting, modeling, and analysis.
- Minimum 1 year of relevant experience in role(s) with responsibility for applying subject matter expertise to operations workflow
- Knowledge and experience with rules around Medicaid / Medicare COB Other TPL business models and products
- Skilled working with operations systems, tools, and applications for collecting and reporting data as well as identifying trends.
- Intermediate skills in MS Excel required.
- Utilization of SQL to run queries.
- Ability to develop basic queries a plus.
- Strong general system and application skills with ability to quickly develop expertise in new systems and applications.
- General knowledge of 270/271, 834, 277, 837, 835 highly desired
- Familiarity with JIRA a plus
- Professional verbal and written communication with good presentation skills
Benefits:
- medical
- dental
- vision
- HSA/FSA options
- life insurance coverage
- 401(k) savings plans
- family/parental leave
- paid holidays
- paid time off annually
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