Operations Expert (US)
Elevance Health

Job Info

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Operations Expert

Location: Must live within 50 miles of the Mason, OH, Norfolk, VA, Richmond, VA, Roanoke, VA, Houston, TX, Columbus, GA, Deerborn, MI, Waukesha, WI, Miami, FL, or Tampa, FL, or Winston-Salem, NC, 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.
  

Minimum Requirements:

• 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.
  

Preferred Skills, Capabilities and Experiences:

• 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.
  

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