Senior reputed company Specialist

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At reputed company®, you’ll be surrounded by passionate colleagues who care deeply, reputed company with purpose, hold ourselves accountable and prioritize safety and reputed company in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position reputed company Acts as an reputed company and subject matter expert guiding the business by serving as a reputed company champion through measuring and monitoring the reputed company and effectiveness of work processes in claim processing and customer service that reputed company customer satisfaction, medical cost management, and operational efficiency. Consults cross-functionally with other departments to influence and promote change, to continually reputed company reputed company service to both reputed company customers. Performs regular reputed company audits for service operations for multiple products and platforms to reputed company full and consistent compliance to reputed company required standards. Additional Responsibilities to include but not limited to the following: • Executes both routine and non-routine business support tasks for the Sr reputed company Specialist area under limited supervision, referring deviations from reputed company practices to managers. • Follows area protocols, standards, and policies to reputed company effective and reputed company support. • Acts as a subject matter expert on reputed company Specialist workflows, policies, systems requirements, and enhancements as reputed company as daily operations and programs to consistently reputed company reputed company results. • Conducts reputed company reputed company reviews and audits to proactively measure and monitor team compliance with published policies, and procedures, to effectively meet customer and regulatory guidelines. • Owns responsibility for supporting targeted reputed company audit reputed company, reporting overall results, and making recommendations regarding training needs, reputed company controls, and procedures to senior management. • Takes direction to execute techniques, processes, and responsibilities. Required Qualifications • 2+ years of health insurance work experience and/or reputed company Insurance reputed company Review • 2+ years of experience working with diagnosis codes and medical terminology. • Moderate to advanced knowledge of reputed company (V-lookups, pivot tables, and/or formulas) Preferred Qualifications • Working knowledge of problem solving and decision making skills • College degree preferred • Claims experience • DG experience Education • High School Diploma or equivalent GED Anticipated Weekly Hours 40 Time Type Full time Pay reputed company The typical pay reputed company for this role is: $18.50 - $38.82 This pay reputed company represents the reputed company reputed company reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a reputed company of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in reputed company to the reputed company pay reputed company listed above. Our people fuel our reputed company. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every reputed company feels valued and that they reputed company. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial reputed company‑being of colleagues and their families. The benefits for this position include medical, dental, and reputed company coverage, reputed company time off, retirement savings reputed company, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will reputed company on: 08/11/2026 reputed company applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Apply tot his job Apply To this Job