Job Title: FEP Claims Quality Analyst

Remote candidates may be considered if located within one hour of Columbus, OH; Salt Lake City, UT; Houston, TX; or Bloomington, MN.

Duration: 6+ months with possibilities of extension
Shift: Day Shift

Job Responsibilities:

• Review FEP transactions to ensure accuracy of transaction and system processing.
• Provide timely documented feedback on issues identified at the processor and/or system level and execute escalation procedures if applicable.
• Maintain flexibility in a team environment and identify process improvement opportunities and define system impacts that may result.
• Participate in departmental knowledge transfer activities to facilitate cross-training efforts.
• Actively represent the FEP Claims Team on various projects and identify required action items and impacts.
• Represent the FEP Claims Team on assigned projects, providing feedback and assessing impacts accordingly.
• Identify FEP process improvements and develop workflow and/or system recommendations.
• Support lead analyst or supervisor in all project-related activities (analysis, tracking, etc.).
• Develop and maintain FEP user documentation ensuring the most current information is available to production areas.
• Communicate effectively in writing and verbally with work groups and internal and external customers.
• Attend internal and external education training to achieve and maintain proficiency on all systems.
• Support assigned projects, maintain appropriate documentation at a task level, monitor deadlines and budget allocations, and serve as a technical liaison when appropriate.
• Assist with designing test plans and evaluate/test new or modified processes and procedures to verify programs or changes conform to established policies, maintaining detailed testing notes, cases, and outcomes.

Required Qualifications:

• FEP Facility Claims Processing and adjustment experience.
• FEP Facility Claims Quality and Audit experience.
• Minimum of 5 to 8 years of work-related experience.
• BS/BA Undergraduate degree or equivalent related experience.

Additional Information:

• Hybrid role preferred for candidates local to the Philadelphia office (3 days onsite per week).
• Remote candidates may be considered if located within one hour of Columbus, OH; Salt Lake City, UT; Houston, TX; or Bloomington, MN.

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