Senior Analyst, Business-Project_Membership&Billing

Versant Health is one of the nation's leading administrators of managed vision care, serving over 35 million of our clients' members across the United States. The Senior Analyst collaborates with the Billing and Enrollment team to analyze, develop, and implement processes for new corporate initiatives and improve existing departmental activities.

Responsibilities:

• Evaluate new projects, initiatives, or departmental processes in need of improvement to create a detailed business analysis, outlining problems, opportunities and solutions for improved business administration
• Evalute departmental interactions with other teams to support requirements building for new initiatives or recommended changes
• Complete analytical review of customer enrollment and billing challenges as it relates to receivable balances due and discrepancy analysis needed
• Oversee documentation and training for the department leads related to the development of new processes and procedures as required
• Lead any new system implementations, upgrades, and/or analysis to support the Enrollment and Billing team, ensuring department needs are met for the administration of team roles in supporting our customers
• Create requests, test, and implement programming changes for system enhancements, upgrades, etc
• Act as a point person for Enrollment and Billing related to needed process changes and improvements; Represent and maintain department interests in those initiatives to ensure continued and improved service to our customers
• Identify, analyze and develop opportunities for enhancements to workflows and processes, as well as quality improvements/review for the department
• Perform data analysis and reporting functions related to Membership & Billing activities
• Field technical questions and inquiries from Membership & Billing Associates, other departments, and vendors
• Analyze and evaluate the current business processes that exist for our Enrollment and billing teams and identify areas of improvement
• Analyze our EDI processes to identify, document and seek completion of improvement initiatives to increase customer support
• Monitor PG results to identify any failed PG’s and identify route cause to determine if business processes or IT support received have process challenges that need modification or attention
• Collaborate with the IT area to complete thorough testing of new and modified processes, software, and other system-oriented transaction sets
• Partner and integrate processes with other operational areas as it pertains to Billing, Collections, Accounts Receivable, and Premium Posting
• Support all established SOC controls in accordance with defined expectations, monitoring weekly to ensure proper completion of tasks and retention of evidence of controls is completed, reviewing and confirming controls completion on a monthly basis
• Develop and maintain effective business relationships with all clients and internal departments
• Adhere to all federal, state, and local regulations, company policies and procedures, and instructions, including guarantees, regulations, and commitments to Clients
• Adhere to privacy, confidential, and proprietary company policies and procedures (i.e. HIPAA)
• Participate in any training and educational activities necessary to fulfill at least the minimum requirements as specified within your departmental goals, in addition to the completion of any activities necessary for the maintenance of professional affiliations or organizational requirements
• Travel to vendor and Versant office approximately 5% of work time
• Complete additional responsibilities as required by changing business needs

Requirements:

• 3+ years of experience in the managed care or health insurance industry, with a working knowledge of Operational Departments such as Eligibility, Premium Billing, Collections, Customer Services, or Claims required
• 3+ in a project role in a health insurer setting, including demonstrated experience in project work, requirements definition, testing, process improvement required
• 3+ years of experience in the administration of membership/EDI enrollment transactions, and billing data processing required
• 3+ years of experience with billing, accounts receivable, discrepancy management and collections functions required
• Direct client interface experience required
• Proficiency in Microsoft Office with experience in Excel sorting, queries, formulas, and charts required