Description

You will manage claims production tasks and ensure compliance with FEP performance metrics and regulations.

This role is on-site.

Responsibilities

• Handle claims production tasks, including written inquiries, reconsiderations, and related adjustments.
• Assess FEP procedures, regulations, and required controls to incorporate them into specifications and documentation.
• Identify process improvements and develop workflow or system recommendations.
• Support FEP audits by researching claims issues, preparing audit responses, and representing the organization during presentations.
• Collaborate with the Business Support team to review release documentation and participate in testing initiatives.

Required Skills

• Deep understanding of FEP policies, processing standards, and guidelines.
• Experience in FEP auditing and quality review.
• Background in claims or service operations environments.
• Ability to map process flows and understand regulatory impacts and timelines.
• Strong written and verbal communication skills for interacting with internal and external customers.
• Experience with transaction processing and maintaining task-level documentation.

Preferred Skills

• Bachelor's degree or Associate degree with at least two years of FEP-related experience.
• Minimum of 4 years of experience in a claims/service operations environment.

Key Skills

Education

Any Graduate