Enrollment Solutions Analyst
About the position
The Enrollment Solutions Analyst at Blue Cross Blue Shield of Louisiana is responsible for advanced operations related to installation, enrollment, and claim integrations with strategic partners. This role involves developing and coordinating enrollment and claims eligibility file feeds, ensuring that solution design, data quality, electronic data interchange, and business processes align with business objectives. The analyst will review and evaluate existing solutions and processes to create data-driven recommendations aimed at improving performance in terms of quality and timeliness. Compliance with all relevant laws and regulations is a critical aspect of this position. In this role, the analyst will not manage any personnel but will work closely with various departments including Information Technology, Business Engineering, Customer Service, Claims, Marketing, and Underwriting. The position requires strong analytical skills and the ability to communicate effectively with both internal teams and external partners. The analyst will be accountable for identifying and evaluating system and process deficiencies, making enhancement recommendations, and developing comprehensive business requirements to meet customer needs and improve process efficiency. The Enrollment Solutions Analyst will also coordinate testing phases for new and modified solutions, ensuring that all programming changes to processing systems are documented, tested, and approved. This position serves as a subject matter expert in enrollment and billing processes, providing insights and recommendations to internal and external workgroups. The analyst will also analyze and process Life and Disability installations and enrollments, ensuring compliance with product, risk, and medical underwriting requirements. Overall, this role is pivotal in ensuring the smooth operation of enrollment and claims processes within the organization.
Responsibilities
Develop and coordinate enrollment and claims eligibility file feeds.
,
Ensure solution design, data quality, electronic data interchange, and business processes meet business objectives.
,
Review and evaluate existing solutions and processes to develop data-driven recommendations for performance improvement.
,
Identify and evaluate system/process deficiencies and make necessary enhancement recommendations.
,
Develop comprehensive business requirements to meet customer needs and improve process efficiency.
,
Coordinate with testers during testing phases, including review and approval of test results.
,
Request, document, test, evaluate, and approve programming changes to processing systems.
,
Serve as an advisor to develop business requirements and gather information to support decisions.
,
Analyze and process Life and Disability installation and enrollment new business, benefit changes, and subsequent enrollments.
Requirements
Bachelor's degree in Business or a related field is required.
,
Four years of related experience can be used in lieu of a Bachelor's degree.
,
Experience in Facets or enrollment system administration, analysis of system reports, and medical/ancillary enrollment processes is required.
,
Strong organizational and analytical abilities with excellent written and verbal communication skills.
,
Experience in developing detailed business requirements and test cases is required.
,
Ability to recognize inconsistencies and gaps in business processes and take corrective actions is required.
Nice-to-haves
Experience with mapping business scenarios to data requirements is preferred.
,
Understanding of interdependencies between business processes and system functionality is required.
,
Experience in project management is preferred.
,
Experience in developing system solutions related to healthcare and membership/enrollment/claims administration is preferred.
Benefits
Health insurance coverage
,
Professional development opportunities
,
Paid time off
,
Flexible scheduling options
,
Employee wellness programs
Apply Now
The Enrollment Solutions Analyst at Blue Cross Blue Shield of Louisiana is responsible for advanced operations related to installation, enrollment, and claim integrations with strategic partners. This role involves developing and coordinating enrollment and claims eligibility file feeds, ensuring that solution design, data quality, electronic data interchange, and business processes align with business objectives. The analyst will review and evaluate existing solutions and processes to create data-driven recommendations aimed at improving performance in terms of quality and timeliness. Compliance with all relevant laws and regulations is a critical aspect of this position. In this role, the analyst will not manage any personnel but will work closely with various departments including Information Technology, Business Engineering, Customer Service, Claims, Marketing, and Underwriting. The position requires strong analytical skills and the ability to communicate effectively with both internal teams and external partners. The analyst will be accountable for identifying and evaluating system and process deficiencies, making enhancement recommendations, and developing comprehensive business requirements to meet customer needs and improve process efficiency. The Enrollment Solutions Analyst will also coordinate testing phases for new and modified solutions, ensuring that all programming changes to processing systems are documented, tested, and approved. This position serves as a subject matter expert in enrollment and billing processes, providing insights and recommendations to internal and external workgroups. The analyst will also analyze and process Life and Disability installations and enrollments, ensuring compliance with product, risk, and medical underwriting requirements. Overall, this role is pivotal in ensuring the smooth operation of enrollment and claims processes within the organization.
Responsibilities
Develop and coordinate enrollment and claims eligibility file feeds.
,
Ensure solution design, data quality, electronic data interchange, and business processes meet business objectives.
,
Review and evaluate existing solutions and processes to develop data-driven recommendations for performance improvement.
,
Identify and evaluate system/process deficiencies and make necessary enhancement recommendations.
,
Develop comprehensive business requirements to meet customer needs and improve process efficiency.
,
Coordinate with testers during testing phases, including review and approval of test results.
,
Request, document, test, evaluate, and approve programming changes to processing systems.
,
Serve as an advisor to develop business requirements and gather information to support decisions.
,
Analyze and process Life and Disability installation and enrollment new business, benefit changes, and subsequent enrollments.
Requirements
Bachelor's degree in Business or a related field is required.
,
Four years of related experience can be used in lieu of a Bachelor's degree.
,
Experience in Facets or enrollment system administration, analysis of system reports, and medical/ancillary enrollment processes is required.
,
Strong organizational and analytical abilities with excellent written and verbal communication skills.
,
Experience in developing detailed business requirements and test cases is required.
,
Ability to recognize inconsistencies and gaps in business processes and take corrective actions is required.
Nice-to-haves
Experience with mapping business scenarios to data requirements is preferred.
,
Understanding of interdependencies between business processes and system functionality is required.
,
Experience in project management is preferred.
,
Experience in developing system solutions related to healthcare and membership/enrollment/claims administration is preferred.
Benefits
Health insurance coverage
,
Professional development opportunities
,
Paid time off
,
Flexible scheduling options
,
Employee wellness programs
Apply Now