Healthcare Claims Functional Analyst

Seeking a Healthcare Claims Functional Analyst! The selected candidate will provides operations support by obtaining facts; analyzing problems; designing solutions; developing testing methods; conducting and documenting tests; providing operating information to customers. We are seeking candidates that have Healthcare/Medical Claims knowledge and can assist with creating and modifying Standard Operating Procedures (SOP) documents around the different claims procedures held by our customer.

-50% Research and improve operations by examining and researching systems problems by obtaining facts, analyzing problems/identifying root cause recommending and facilitating resolution.
-20% Supports operations systems by providing operating information to customers; answering questions; providing training.
-20% Contributes to operations analysis and organization success by welcoming related, different, and new requests; helping others accomplish job results, development of Standard Operating Procedures (SOP) and other essential documentation
-5% Verifies operations systems by developing testing methods; conducting and documenting tests.
-5% Improves operations analysis job knowledge by attending training sessions; reading technical publications.

Although this position is 100% remote, we are seeking candidates that reside in the following states: Wash DC, MD, VA, WV, NC, PA, DE, NY, NJ, TX, FL. This position is a 12 month contract to permanent opportunity with our customer, a major healthcare insurance organization.

Required Skills

-Education Level: Bachelor's Degree. In lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience.
-Experience: 2 years experience as a Claims Functional Analyst
-Must have previous history in creating and/or modifying Standard Operating Procedures (SOP) and other essential documentation. Solid writing skills are important
-MS Excel experience is required
-Solid communication/customer service skills are required
-Healthcare Enrollment knowledge is a big plus
-Ability to recognize, analyze, and solve a variety of problems.

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Anticipated Start Date

Monday, October 30, 2023

Job Type


Anticipated Duration

12 month T2P

Date Posted

Friday, October 6, 2023

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Elite Technical Services, Inc. participates in the E-Verify program to confirm the employment eligibility of all persons hired. This means that we will provide the Social Security Administration (SSA) and, if necessary, the Department of Homeland Security (DHS), with information from each new employee's Form I-9 to confirm work authorization. Elite Technical Services, Inc. will not use E-Verify to pre-screen job applicants.

Elite Technical Services, Inc. is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.