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Operations Technical Analyst I - Req. # : 010913531B
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Operations Technical Analyst I
Gilsbar Covington, LA, US 70433
Administrative / Clerical
Date Needed By
This position is responsible for set up and maintenance of information systems processes that support data management in the Health and Life Operations department.
ESSENTIAL DUTIES AND RESPONSIBILITIESinclude the following. Other duties may be assigned.
* Assists in set-up of new groups and new lines of business in a variety of programs within the Genelco system.
* Coordinates set-up specifications with other departments including claims, Technology, Finance and Excess Risk Claims.
* Schedule and distribute various internal reports for use by H&L Ops teams.
* Monitor EDI claims processes. Troubleshoot and refer escalated issues to supervisor or manager.
* Work with outsourced process vendors, including PBMs and PPOs to set up new connections and implement process efficiencies.
* Updates changes to existing groups and lines of business in Genelco system.
* Enters data for and maintains group set-up documentation.
* Assist with mapping eligibility data.
* Enters data for rate tables, factor tables, zip code tables, plan code tables, class code tables, reason codes, product definitions, product masters, plan masters, product set masters and any other factors/tables necessary to calculate accurate premiums and benefit information.
* Responsible for set-up and maintenance of billing formats.
* Researches and resolves errors reported on the billing error reports.
* Acts as first point of contact for assistance from users experiencing problems with the Genelco system. Refers escalated issues to Supervisor.
* Maintains problem resolution documentation.
* Assists users with billing and eligibility issues.
Bachelor’s degree in Business Administration, Finance or Accounting from a four-year college or university; or a minimum of two years related experience and/or training; or equivalent combination of education and experience.
# of Hires Needed