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.

ESSENTIAL FUNCTIONS:
-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.