Operations Expert - Paragon Infusion Centers

Elevance Health•Plano, TX

9d•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. This role acts as a first level SME, with abilities beyond intake calls that include working on production-oriented work, and may include physician assisting and/or special projects. The Operations Expert serves as a first line resource for operation associates for workflow and technical related processes, provides operational training, and assists associates by answering day-to-day technical questions. They monitor inventory to ensure workflow remains uninterrupted, handle complex case research and resolution, and review, interpret and maintain records of service level, quality, accuracy, and productivity. Additionally, they review department policy and procedure manuals for accuracy and work with the training department to ensure procedures and policies are accurate and complete. Associates in this role are expected to multi-task, including handling calls, texts, facsimiles, and electronic queues, while simultaneously taking notes and speaking to customers. They must be proficient in maintaining focus during extended periods of sitting and handling multiple tasks in a fast-paced, high-pressure environment, possess strong verbal and written communication skills, be attentive to details, a critical thinker, and a problem-solver, and demonstrate empathy and persistence to resolve caller issues completely. Comfort and proficiency with digital tools and platforms to enhance productivity and minimize manual efforts are also expected. 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

HS diploma or equivalent
Minimum of 5 years related experience
Minimum of 3 years of directly related experience and expertise with company relevant automated processing systems
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.

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

Acts as a first level SME, ability beyond intake calls that include working on production oriented work, may include physician assisting and/or special projects.
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.
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.
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.