Healthcare Utilization Analyst Job at USA Talent Solutions, Indiana, PA

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  • USA Talent Solutions
  • Indiana, PA

Job Description

Job Title: Healthcare Utilization Analyst

Location: Indiana, PA (on-site)

Type: Full-Time, Permanent

Salary: $20 - $24/hr

Our client, located in Indiana, PA, is looking for a Healthcare Utilization Analyst who will be responsible for maintaining data and producing various documents, such as invoices, standard reports, custom reports, and supporting documentation.

This is a great opportunity for the right person to join an AMAZING company!! Our client is a highly recognized leader in property & casualty insurance, employee benefits programs, and as an employer of choice!

Responsibilities:

Billing

  • Prepare and analyze invoices and related reports from the Bdb system or other carrier sources and distribute. This includes Snapshot Billing preparation, analysis and distribution.
  • Prepare monthly stop loss, administrative, COBRA, or other fee-related invoices and assist with supporting reports to show loss ratios for stop loss coverage.
  • May assist with tracking invoice payments and follow up with clients to resolve payment discrepancies and late payments.
  • Work with the Benefit Administration Specialists and carriers to ensure that correct rates are maintained and invoiced to clients.
  • Prepare ancillary (dental/vision/life/STD/LTD/LTC) billing

Reporting

  • Collect financial and healthcare utilization information and prepare reports (including loss ratios, financial and utilization reports) on a scheduled basis (monthly, quarterly, semi-annually, annually, and on as-needed basis). Examples may include the following:
  • Maintain weekly and monthly reports from direct wire transmissions with regard to the Agency’s self-insured (e.g. ASO/ASC) clients
  • Prepare Stop Loss Reporting
  • Complete other reporting functions as assigned by the Senior Healthcare Utilization Analyst, Director of Financial Reporting, or VP of Benefits.

General

  • Back up other department personnel as needed
  • Tech check reports and charts as needed/requested
  • Maintain files related to stop loss checks and prepare letters when required.
  • Assist with audit requests.
  • Prepare yearend outcome statements for the consortiums
  • Quote information files
  • Create emails in secure messaging system
  • Set up new users for secure messaging in Bdb
  • Review stop loss contracts from carrier at renewal
  • Become acclimated to and effectively use various vendor reporting
  • Coordinate department duties with others

Skills & Abilities:

  • Advanced Excel skills
  • Strong analytical skills
  • Accuracy and attention to detail
  • Ability to communicate both orally and in writing with clients, carriers, and co-workers.
  • Function with a high degree of independence in order to complete specific projects and standard responsibilities.
  • Use creativity in displaying concise and visually appealing information.
  • Looks for ways to optimize work processes by knowing the most effective and efficient process to get things done while focusing on continuous improvement.
  • Visual ability to read computer screens and output.
  • Physical dexterity to be able to utilize computers and general office equipment.
  • Assist other departmental employees in solving technical problems or by participating in other Agency projects.
  • Ability to work under pressure and mental stress; ability to establish priorities.
  • Ability to lift and transport objects and supplies of less than 10 pounds without assistance.
  • Personal computer experience required.

Experience & Education:

  • Bachelor’s degree in related field or relevant experience.
  • State life, accident and health insurance license required.
  • Group insurance experience preferred.
  • Knowledge of managed care and experience with design, implementation and funding of such plans preferred.

Job Tags

Permanent employment, Full time,

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