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Operations Representative at SHA Strategic Health Alliance II, Inc. in Middleburg Heights, Ohio

Posted in General Business 30+ days ago.

Type: Full-Time





Job Description:

This role, reporting to the ProviderPay Operations Supervisor, is responsible for the daily management of claims data and coordination for current customers. This role manages paper-based remittance advice, ensuring qualified claims are identified and moved forward in the reconciliation process. Proactively obtains needed remittance detail from appropriate third-party payers to include in reconciliation process. Conducts routine audits and process flow reviews to ensure accuracy and efficiency. Collaborates with internal team members to research and resolve reported issues for current customers.

Minimum Job Qualifications (Knowledge, Skills, & Abilities):

Requires 3+ years of related experience  

Business Experience:


  • 2+ years’ experience in healthcare payment and claims processing or healthcare industry business process.

  • MS office experience, SQL Query experience.

  • Strong attention to detail.

  • Advanced speed and accuracy managing data and data entry.

Education/Training: Associate/ Bachelor’s degree preferred.

Specialized Knowledge/Skills: Managed care experience. Pharmacy operations / claims adjudication knowledge or experience. Pharmacy reimbursement / reconciliation knowledge or experience.  
 
Working Conditions: Environment (Office, warehouse, etc.) – General Office 
  
Physical Requirements (Lifting, standing, etc.) – General office 
 

McKesson is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, creed, sex, sexual orientation, gender identity, national origin, disability, or protected Veteran status.Qualified applicants will not be disqualified from consideration for employment based upon criminal history.McKesson is committed to being an Equal Employment Opportunity Employer and offers opportunities to all job seekers including job seekers with disabilities. If you need a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to Disability_Accommodation@McKesson.com. Resumes or CVs submitted to this email box will not be accepted.Current employees must apply through internal career site.Join us at McKesson!