Sr Analyst, Enrollment Job Vacancy in Evolent Health Pune, Maharashtra – Latest Jobs in Pune, Maharashtra
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Full Details :
Company Name : Evolent Health
Location : Pune, Maharashtra
Position :
Job Description : It’s Time For A Change…
Your Future Evolves Here
Evolent Health has a bold mission to change the health of the nation by changing the way health care is delivered. Our pursuit of this mission is the driving force that brings us to work each day. We believe in embracing new ideas, challenging ourselves and failing forward. We respect and celebrate individual talents and team wins. We have fun while working hard and Evolenteers often make a difference in everything from scrubs to jeans.
Are we growing? Absolutely – about 40% in year-over-year revenue growth in 2018. Are we recognized? Definitely. We have been named one of “Becker’s 150 Great Places to Work in Healthcare” in 2016, 2017, 2018 and 2019, and one of the “50 Great Places to Work” in 2017 by Washingtonian. We recognize employees that live our values, give back to our communities each year, and are champions for bringing our whole selves to work each day. If you’re looking for a place where your work can be personally and professionally rewarding, don’t just join a company with a mission. Join a mission with a company behind it.
What You’ll Be Doing:
Position summary
This position requires maintaining accurate member records. Entering system eligibility and/or enrollment data on a daily basis including new enrollees, change in circumstance terminations, PCP’s and broker information.
Essential functions
Research 834 X12 Files
Display proficiency in working in Excel (sorting, updating records required; vLookup and Pivot Table experience preferred)
Adjusts premiums and rates for financial billing as directed/required
Correspond and communicate with the groups, brokers, and clients.
Generate reports as needed (i.e. daily, monthly, and /or year-end).
Remain informed of developments in area of expertise by attending conference calls, webinars, reading pertinent literature and so forth.
Key competencies/skill/success factors:
Understanding of X12 files, 834 files, paper enrollment, and billing/invoicing.
Understanding of claim processing environment and knowledge of claim adjudication process/concepts.
Experience in process improvement that utilizes six sigma, kaizen, and/or other process improvement methodologies in a transactional environment or has experience in being involved in process improvement in general that tie into measurable results.
Overall understanding of health care benefit administration.
Ability to communicate in an effective manner to drive results and maintain positive team atmosphere.
Ability to communicate to other internal business teams during cross-functional projects and ability to implement conflict resolution strategies.
Ability to document processes and/or provide guidance to business analyst to ensure proper documentation is developed.
The interpersonal skills necessary include the ability to work well within a team that includes all levels within the organization from clerical and support staff to senior management as well as clients and brokers outside of the organization.
Understands working in a health benefit administration, Third Party Administrator, or Pre-Tax Benefit environment
Understands and can work in a production environment in which performance is tied to operational metrics
Integrity and discretion to maintain confidentiality of member’s HIPAA data.
Strong analytical ability necessary to work, discover and outline systems related issues on own as well as within a team.
The ability to take the lead on projects and recommend and implement process to complete work.
Proficient in MS Excel and MS Word.
Qualification and Experience:
4 year College degree or equivalent work experience
Knowledge of health insurance operations
This post is listed Under Education
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