Operations Expert

Elevance Health•Plano, TX

2d•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 requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. 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.

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.
Performs other duties as assigned.