Serve as a subject-matter expert for Medical Bill Review (MBR) operations
Providing advanced production support, driving process improvements, and coordinating cross-functional issue resolution and project execution
Support the processing of workers’ compensation medical and pharmacy bills from bill intake through bill payment
Work directly with Berkley Operating Units to investigate bill processing issues
Responsible for problem-solving, identifying and triaging issues to technical teams
Interface with multiple vendors to facilitate issue resolution, issue documentation, tracking, and reporting
Independently and as part of a team identify issue commonalities and root causes to assist in solution design, monitoring, and controlling

MBR business process SME including experience with MBR E2E process from a business/operations perspective
Firm understanding of integrated services and workflows including FS/UCR, Nurse and code review, PPO, negotiations, adjustor bill adjudication
Workers compensation regulatory environment experience/understanding
Demonstrated application of successful critical thinking and complex problem solving skills
Experience in a role requiring deep understanding of and experience working with MBR and integrated services technology – not at a developer level – but from a business analyst perspective
Experience gathering business requirements and clearly documenting complex scenarios and use cases to communicate MBR issues accurately for resolution
Communication experience with varied audiences including leadership and peers in business/operational & technology roles
Client-facing acumen
Team-player
Experience with Atlassian/JIRA/SQL

Operations Analyst – Medical Bill Review

Key skills