Senior Government Operations Analyst
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Job Description
Senior Operations Business Analyst providing support across Claims, Customer Service, Enrollment & Billing, and Appeals & Grievances. Focusing on Medicare Advantage appeals and claims processing workflows.
Responsibilities:
- Serve as a department project lead for corporate and departmental initiatives, including those involving appeals & grievances reporting, claims operational enhancements, and regulatory changes.
- Provide written and verbal status updates, identify risks, perform root cause analyses, and recommend process improvements.
- Mentor less experienced staff, including informal coaching on reporting, appeals workflows, systems navigation, and documentation standards.
Requirements:
- 3 years of experience working with integrated business systems handling claims, appeals & grievances, membership, and customer service processes.
- Strong written and verbal communication skills, able to translate technical reporting, regulatory requirements, and operational data into business‑friendly insights.
- Bachelor’s degree in business administration, health administration, information systems, computer science, or related field preferred.
Benefits:
- Medical, Dental & Vision coverage
- Retirement Plan
- Generous time off including Paid Time Off, Holidays, and Volunteer time off
- Incentive Plan
- Tuition Reimbursement
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