Healthcare Utilization Analyst

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.