Process Expert II - Claims

Elevance Health • Columbus, OH

4d • Hybrid

About The Position

Process Expert II - Claims Location: Ohio. 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. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The MyCare Ohio Plan program is to deliver high‐quality, trauma informed, culturally competent, person‐centered coordination for all members that addresses physical health, behavioral health, long term services and supports, and psychosocial needs. The Process Expert II supports the claims issue research and resolution for Home & Community Based Services (HCBS) by participating in project and process work. How you will make an impact Primary duties may include, but are not limited to: Researches operations workflow problems and system irregularities. Develops tests, presents process improvement solutions for new systems, new accounts and other operational improvements. Develops and leads project plans and communicates project status.

Requirements

• Requires a BA/BS and minimum of 5 years experience in business analysis, process improvement, project coordination in a high-volume managed care operation (claims, customer service, enrollment and billing); or any combination of education and experience, which would provide an equivalent background.

Nice To Haves

• Ability to analyze workflows, processes, supporting systems and procedures and identifying improvements strongly preferred.
• Claims issue research and resolution for Home & Community Based Services (HCBS) highly preferred.
• Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.

Responsibilities

• Researches operations workflow problems and system irregularities.
• Develops tests, presents process improvement solutions for new systems, new accounts and other operational improvements.
• Develops and leads project plans and communicates project status.

Benefits

• In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).
• We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees