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Business Process Advisor
2 months ago
**MUST live in NY, NJ, CT, VT, or FL
Our client is a reputable health care enablement company that strives to provide innovative, customizable, and sustainable solutions that encourage patient activation and improve the quality of care. They are looking to hire a Business Process Advisor to join their team and assist with managing healthcare payer processes end to end covering plan administration. This is a wonderful contract opportunity that offers a fully remote work schedule, and we are looking to fill the position as quickly as possible.
Responsibilities:
- Claims Integration with BlueCross or CIGNA/AETNA.
- Claims Administration and payments.
- Establish metrics to monitor the effectiveness of processes and make adjustments as needed to ensure continuous improvement.
- Lead the implementation of new processes, including coordinating with relevant stakeholders, training staff, and monitoring the transition.
- Assess current business processes to identify inefficiencies, bottlenecks, and opportunities for improvement.
- Billing and Invoicing.
- Vendor Carrier Integration.
- Member and Provider experience.
- Documenting and vetting the current state and future state process maps with key stakeholders internally and clients.
Qualifications:
- At least 5 years of experience.
- Bachelor's degree or equivalent experience.
- MUST have healthcare experience.
- MUST have an understanding of claims.
