Healthcare Operations Support Specialist (SCA)

United StatesRemotemid

Customer SupportOperations Support Specialist

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Quick Summary

Overview

Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plan clients across the country.

Technical Tools

Customer SupportOperations Support Specialist

Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plan clients across the country. Deployed by over 85 health plans, including many of the top 20, and representing more than 270 million lives, Machinify brings together a fully configurable and content-rich, AI-powered platform along with best-in-class expertise. We’re constantly reimagining what’s possible in our industry, creating disruptively simple, powerfully clear ways to maximize financial outcomes and drive down healthcare costs.

The HCS Operations Support Services team performs activities to healthcare audit client inventory activities such as claim re-pricing, client inventory status reporting, responding to client inquiries, researches and resolves issues that may arise, and other client account ad-hoc reporting and inventory support activities. This position supports short and long term operational/strategic business initiatives, working closely with the business units and the audit teams as well as other team members to ensure on-time deliverables.

Responsibilities

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Monitors internal and external reports and take specific actions based on the information
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Responds to client correspondence and email request for information
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Maintains provider information
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Re-prices claims using client contracts and systems
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Creates, documents, and modifies processes for new and existing clients as needed
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Participates in special ad hoc projects and program initiatives as assigned
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Contributes to team effort by completing assigned projects on time
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Receives feedback and adjusts work priority as necessary
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Performs other duties as assigned

Outstanding written and verbal communication skills
Good critical thinking, questioning, and listening skills; excellent attention to detail
Problem-solving and task management skills
Time management skills for managing multiple tasks simultaneously, while completing work within allocated time frames
Ability to handle changing situations and work within a diverse group
Strong Microsoft Office suite knowledge
Ability to work independently but also as a member of a team
Ability to meet objectives with minimal supervision
Strong technical skills are desired
Ability to work effectively with diverse teams is desired
Can meet objectives with minimal supervision

Requirements

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High School Diploma/GED is required
Some college, Associate's or Bachelor’s degree preferred
Health care data analysis experience including gathering and documenting requirements for projects of all sizes a plus.
Experience using Microsoft Excel and other Microsoft Office applications.

Equal Employment Opportunity at Machinify

We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender, gender identity or expression, or veteran status. We are proud to be an equal opportunity workplace. Machinify is an employment at will employer. We participate in E-Verify as required by applicable law. In accordance with applicable state laws, we do not inquire about salary history during the recruitment process. If you require a reasonable accommodation to complete any part of the application or recruitment process, please let our recruiters know. See our Candidate Privacy Notice at: https://www.machinify.com/candidate-privacy-notice/