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.

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