Work closely with the operations teams and data team to ensure inventory is accurately and efficiently distributed/assigned and transferred across teams based upon applicable inventory type workflow and requirements.
Conduct auditing of operations team activities on inventory to validate compliance with internal requirements, client contracts, regulatory requirements, and industry quality standards.
Facilitate communications and collaborate to convey/clarify requirements for inventory data flow based upon client/type/source serving as a liaison between the operations and eligibility & analytics data team.
Utilize SQL queries (and develop queries as may be needed) and leverage subject matter knowledge, independent judgement, and analytical skills to: Test data transfer/flow results.
Perform audit activity. Create and maintain regular internal/external activity and metrics reporting; and Other support for operations workflow and activity. Mentors operations team and data team on paper and electronic claims processes

Bachelor’s degree in relevant field, or equivalent combination of education and experience
At least three (3) years of directly related progressive experience (claims, billing, eligibility, Medicaid/Medicare, etc.)
Minimum two (2) years relevant experience demonstrating ability to work with large volumes of healthcare eligibility or client data, including data reporting, modeling, and analysis.
Minimum 1 year of relevant experience in role(s) with responsibility for applying subject matter expertise to operations workflow
Knowledge and experience with rules around Medicaid / Medicare COB Other TPL business models and products
Skilled working with operations systems, tools, and applications for collecting and reporting data as well as identifying trends.
Intermediate skills in MS Excel required.
Utilization of SQL to run queries.
Ability to develop basic queries a plus.
Strong general system and application skills with ability to quickly develop expertise in new systems and applications.
General knowledge of 270/271, 834, 277, 837, 835 highly desired
Familiarity with JIRA a plus
Professional verbal and written communication with good presentation skills

HCS Operations Inventory & Quality Analyst – Eligibility

Key skills