Description
SME / Process Leader Candidate Expectation: Advanced knowledge of Computer, Internet and Microsoft Office products Excellent communication skills in English (written & Verbal) Critical analysis and logical skills Proven experience and ability to meet quality standards (timeliness and accuracy) Prior team lead experience Previous US health insurance experience preferably in Claims Ops Prior Benefit Coding or Benefit Systems Analyst/IT experience, a plus Job Descrption: Collects and analyzes data about business needs, assists in determining specific business application software requirements, and ensures requirements are incorporated into system designs and testing Builds and enters standard benefit plans with the appropriate plan provisions and state mandates for various medical products Researches and responds to standard inquiries from various departments. Provides support with a focus on customer satisfaction. Demonstrates and applies an understanding of state mandates and the plan provisions contained in the certificate of insurance.


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