Operations Expert (US) at Elevance Health in Mason, Ohio

Job Description:

Operations Expert




Location: Must live within 50 miles of the Norfolk, VA, Roanoke, VA, Mason, OH, Miami, FL, or Tampa, FL PulsePoints.


The Operations Expert is responsible for providing technical direction, guidance and resources to claims, customer service, or membership associates on a day-to-day basis.



How you will make an impact:

• Serves as a first line resource for operation associates for workflow and technical related processes.
  
  


• Provides operational training; assists associates by answering day-to-day technical questions.
  
  


• Encourages a teamwork environment.
  
  


• Monitors inventory to ensure workflow remains uninterrupted.
  
  


• Handles complex case research and resolution.
  
  


• Reviews, interprets and maintains records of service level, quality, accuracy, and productivity.
  
  


• Reviews department policy and procedure manuals for accuracy.
  
  


• Works with training department to ensure procedures and policies are accurate and complete.
  
  

• Requires HS diploma or equivalent and a minimum of 5 years related experience and a minimum of 3 years of experience and expertise with company relevant automated processing systems; or any combination of education and experience which would provide an equivalent background.
  
  

• Previous leadership experience preferred.
  
  


• Medicare Claims experience highly preferred
  
  


• For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills preferred.