Quality Assurance Analyst

Novalink Solutions LLC•Mason Township, OH

About The Position

This role supports OSHP program managers and EIU case managers in addressing vendor queries related to historical member benefits enrollment and eligibility information. The analyst will also support the OSHP life insurance program manager and Benefits Initiation Section 3 staff in administering life insurance enrollment and eligibility, handling escalated eligibility and enrollment questions resulting from discrepancies between the My Insurance Benefits system, Securian Financial billing system, and employer records. Additionally, the role involves supporting the Life Insurance Premium Waiver interim process, assisting in the development and documentation of new ETF procedures related to eligibility and enrollment administration for the life insurance program, conducting the life insurance salary audit, and supporting the vendor file discrepancy process following MIBs implementation. The analyst will also conduct full-file comparisons and data reconciliation activities, research, analyze, and troubleshoot eligibility and enrollment discrepancies, assist with monitoring and resolving vendor file transmission issues, and support testing and validation activities related to eligibility, enrollment, and vendor file changes or system updates.

Requirements

Attention to detail
Ability to research, interpret, and apply relevant WI Statutes, Admin Code, policies and procedures
Ability to analyze and compare large data sets and files to identify discrepancies, inconsistencies, and trends
Ability to investigate and determine root causes of data or file discrepancies in collaboration with technical staff, vendors, and business teams
Working knowledge of data exchange processes, file layouts, and/or eligibility and enrollment data
Experience troubleshooting data issues and documenting findings, resolutions, and procedures
Intermediate proficiency in Microsoft Excel, including formulas, filtering, sorting, pivot tables, and lookup functions
Ability to understand and communicate complex data and information to both technical and non-technical audiences
Critical and analytical thinking for effective problem-solving
Working collaboratively with different teams across an organization
Capacity to learn new tools, systems, applications, and ability to document procedures to assist others in using
Sound time management and ability to manage multiple, concurrent assignments
Obtain relevant information without disclosing confidential information
Ability to interact positively with a variety of persons at different levels
Excellent written, oral, and interpersonal skills
Minimum of three (3) years of professional experience in benefits administration, eligibility and enrollment operations, insurance operations, or a closely related field, including interpretation and application of statutes, administrative code, policies, procedures, and business rules.
Minimum of three (3) years of professional experience in data analysis, reconciliation, and validation across files, reports, and systems to identify discrepancies, inconsistencies, and trends, including use of Microsoft Excel for comparison and analysis.
Minimum of three (3) years of professional experience in research and resolution of eligibility, enrollment, billing, or vendor file discrepancies, including root cause identification, corrective action coordination, and documentation of findings and outcomes.
Minimum of three (3) years of professional experience serving as a liaison between internal staff, technical teams, vendors, and stakeholders to communicate issues, exchange information, and support resolution of complex eligibility and enrollment issues.

Nice To Haves

Advanced Microsoft Excel skills, including use of formulas, pivot tables, lookup functions, filtering, and sorting to analyze and compare large or complex data sets.
Experience performing data reconciliation and file comparison across multiple systems to identify discrepancies and support data integrity and issue resolution.
Knowledge of eligibility, enrollment, and benefits administration processes, including understanding of data exchange between employers, vendors, and internal systems.
Strong analytical and problem-solving skills, including ability to investigate data issues, identify root causes, and support resolution in collaboration with technical and business partners.
Strong communication, organization, and documentation skills, including ability to clearly convey complex information, manage multiple priorities, and document findings and resolutions.

Responsibilities

Support OSHP program managers and EIU case managers in addressing vendor queries related to historical member benefits enrollment and eligibility information.
Support OSHP life insurance program manager and Benefits Initiation Section 3 staff in administering life insurance enrollment and eligibility, handling escalated eligibility and enrollment questions resulting from discrepancies between My Insurance Benefits system, Securian Financial billing system, and employer records.
Support the Life Insurance Premium Waiver interim process.
Assist in the development and documentation of new ETF procedures related to eligibility and enrollment administration for the life insurance program.
Conduct the life insurance salary audit, verifying consistency between employer reported salary information and current on file information; work with EIU case managers to resolve errors.
Support the vendor file discrepancy process following MIBs implementation—reviewing error reports returned from Benefitfocus, determining updates needed in system, from employers, or by plans.
Conduct full-file comparisons and data reconciliation activities between vendor, employer, and ETF systems to identify discrepancies and ensure data integrity.
Research, analyze, and troubleshoot eligibility and enrollment discrepancies, coordinating with ETF technical staff, vendors, and business teams to identify root causes and implement corrective actions.
Assist with monitoring and resolving vendor file transmission issues, including 834 file processing and SFTP connectivity concerns.
Support testing and validation activities related to eligibility, enrollment, and vendor file changes or system updates.