Operations Expert

Elevance Health•Plano, TX

8d•Hybrid

About The Position

The Operations Expert is responsible for providing technical direction, guidance and resources to operations, claims, customer service, or membership associates on a day-to-day basis. Associates in this role are expected to have the ability to multi-task, including handling calls, texts, facsimiles, and electronic queues, while simultaneously taking notes and speaking to customers. Proficient in maintaining focus during extended periods of sitting and handling multiple tasks in a fast-paced, high-pressure environment; strong verbal and written communication skills, both with virtual and in-person interactions; attentive to details, critical thinker, and a problem-solver; demonstrates empathy and persistence to resolve caller issues completely. Comfort and proficiency with digital tools and platforms to enhance productivity and minimize manual efforts. Associates in this role will have a structured work schedule with occasional overtime or flexibility based on business needs, including the ability to work from the office as necessary. Performs other duties as assigned.

Requirements

Requires HS diploma or equivalent and a minimum of 5 years related experience which includes a minimum of 3 years of directly related experience and expertise with company relevant automated processing systems; or any combination of education and experience which would provide an equivalent background.

Nice To Haves

Previous leadership experience.
5+ years' experience with healthcare benefit referrals, authorizations, appeals, and cost estimates.
Healthcare Commercial and Government experience.
NextGen experience.

Responsibilities

Serves as a first line resource for operation associates for workflow and technical related processes.
Provides operational training; assists associates by answering day-to-day technical questions; encourages a teamwork environment.
Monitors inventory to ensure workflow remains uninterrupted; handles complex case research and resolution.
Reviews, interprets and maintains records of service level, quality, accuracy, and productivity.
Reviews department policy and procedure manuals for accuracy; works with training department to ensure procedures and policies are accurate and complete.