Process Expert, Grievance and Appeals at Elevance Health

Posted in Other 12 days ago.

Location: Norfolk, Virginia





Job Description:

Process Expert, Grievance and Appeals




Location: This position will work a hybrid model (1-2 days/week). The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations.


The Process Expert assists in identifying and researching workflow problems and system irregularities.



How You Will Make an Impact:



  • Monitors reports/has oversight of Intake Site.


  • Reviews adjustment requests submitted to Intake site for accuracy and clarifies requests with the submitter as appropriate.


  • Receives guidance and mentoring from more experienced process experts.


  • Researches operations workflow problems and system irregularities; assists with the development and testing of process improvement solutions for new systems, new accounts and other operational improvements; assists with the development and leading of project plans and communicating project status.





Minimum Requirements



Requires a BA/BS and minimum of 3 years related experience (business analysis, process improvement, project coordination), experience in high-volume managed care operations (claims, customer service, enrollment and billing); or any combination of education and experience, which would provide an equivalent background.



Preferred Skills, Capabilities and Experiences:



  • Visio experience is strongly preferred.


  • Strong skills in Word and Excel are preferred.


  • SharePoint experience is preferred.


  • Ability to analyze workflows, processes, supporting systems, procedures and identifying improvements strongly preferred.



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