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Claims Operations Specialist

1 month ago

Philadelphia, Pennsylvania, United States IntePros Full time
Claims Operations Analyst

IntePros is seeking a skilled Claims Operations Analyst to join our team in Center City Philadelphia. As a key member of our operations team, you will be responsible for handling claims production tasks, supporting business operations, and identifying process improvements.

Key Responsibilities:
  • Claims Production: Handle written inquiries, reconsiderations, and related adjustments to meet FEP Performance metrics.
  • Process Improvement: Identify areas for improvement and develop workflow and system recommendations.
  • Support and Collaboration: Support FEP audits, research claims-related issues, and prepare audit responses. Collaborate with the Business Support team to review FEP release documentation and participate in testing initiatives.
  • Documentation and Communication: Develop and maintain user documentation and desk-level procedures. Communicate effectively with internal and external customers through written and verbal communication.
  • Professional Development: Attend internal and external education training to maintain proficiency on all systems.
Requirements:
  • Education and Experience: High School Diploma or GED, 4 years' experience in a Claims/Service operations environment, or Associate degree with minimum 2 years' Federal Employee Health Benefits Plan work-related experience. Bachelor's degree preferred.
  • Skills and Knowledge: Knowledge of systems, process flows, regulatory impacts, and timelines. Excellent written and verbal communication skills. Ability to maintain flexibility in a team environment and identify process improvement opportunities.