Process Expert I

Process Expert I

Process Expert I assists in identifying and researching workflow problems and system irregularities. Primary duties may include but are not limited to :

• Monitors reports / has oversight of Intake Site.
• Reviews adjustment requests submitted to Intake site for accuracy and clarifies requests with the submitter as appropriate.
• Receives guidance and mentoring from more experienced process experts.
• Researches operations workflow problems and system irregularities; assists with the development and testing of process improvement solutions for new systems, new accounts and other operational improvements; assists with the development and leading of project plans and communicating project status.

Minimum Requirements : Requires a BA / BS and minimum of 3 years related experience (business analysis, process improvement, project coordination), experience in high-volume managed care operations (claims, customer service, enrollment and billing); or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences : Experience in overpayment adjustments Systems- FACETS, NextGen, CI&W.

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.

Job Level : Non-Management Non-Exempt

Workshift : 1st Shift (United States of America)

Job Family : BSP >

Process Improvement

Elevance Health is a health company dedicated to improving lives and communities and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient / member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.