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Claim Denial Workstream Lead
3 months ago
Leader of Claim Denial Communications workstream.
Tasks include:
Working with Data Science and Analytics to gather background on denied claim types.
Review the data for key insights.
Use discovered insights and program tenants to help craft new explanation language.
Language is co-crafted using an existing workgroup of folks that span multiple orgs in the company. You are there to influence the right change based on your subject matter expertise using data insights.
Track denials touched and changes made across multiple applications (Excel Workbook).
Partner with broader program team to help everyone stay informed of changes (weekly meetings, IM chats, etc.).
Attending application requirements meetings as the denied claims subject matter expert.
May have to prepare or contribute to presentations.
Required Skills
At least 1 year of experience in Health Insurance is desired.
Must be passionate about making things better.
Must be able to meet deadlines (25 rewrites per quarter).
Good communication and EQ skills are critical to success.
Must be able to work as part of a diverse team - know your role within the team for sphere of influence.
Lean/Six Sigma certification desired.Knowledge of Net Promoter Score work desired.
Hands-On knowledge of Microsoft Office REQUIRED (Outlook, PowerPoint, Excel).
Experience with Miro desired.
Must be comfortable working independently - Once onboarded, you are the workstream leader and have full responsibility for meeting deadlines and achieving desired results.
Benefits (employee contribution):Health insurance
Health savings account
Dental insurance
Vision insurance
Flexible spending accounts
Life insurance
Retirement plan
ll qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
