Performance Measurement Specialist I - Auditor

Location
Virginia Beach, VA
Salary
Competitive
Posted
Dec 21, 2018
Closes
Jan 24, 2019
Ref
118839BR
Function
Other
Industry
Other
Hours
Full Time
Overview:

Optima Healthcare is currently recruiting for a Performance Measurement Specialist to work in their Virginia Beach location!

Experience:
Minimum 2 years Training experience in the Customer Operations/Claims field
2 years Claims and Customer Service experience is REQUIRED
Prior Auditing experience is PREFERRED
Prior Managed Healthcare experience is REQUIRED

Shift - Day shift, M-F. Full Time - 40 hrs/wk
Location: Virginia Beach Blvd. and Witchduck Rd. area

•Ability to adapt to changes in process
•Detailed in all aspects of work
•Excellent customer service skills both to external customers and internal customers
•Ability to work on a team but also function independently
•Ability to recognize the importance of prior authorization and its impact on the provider and the member affected
•Familiarity with Medical Terminology
•Previous health insurance companies is a plus.

This position is with our Optima Community Care division of Shared Services


Other
2 years experience in Claims Processing, Customer Service, Enrollment or System Adminstration required

Responsibilities:

The position is responsible for providing hands on training to the Customer Operations Department as well as other departments as needed. The Performance Measurement Analyst serves as a resource for the Customer Operations staff and external departments, providing on-going and consistent training as required. Performs random and focused audits relative to all operational functions within Customer Operations.

Qualifications:

Education Level
High School Grad or Equivalent

Experience
Required: Training - 2 years

Preferred: None, unless noted in the "Other" section below

License
None, unless noted in the "Other" section below

Skills
Required: Communication, Instructing, Microsoft Office, Speaking

Preferred: None, unless noted in the "Other" section below

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