Collabera Operations Specialist in Mason, Ohio

Operations Specialist

Location:Mason, OhioUS

Posted On:5/17/2018

Job Code:AditiOPOH

Job Description

Collabera is looking to fill a Operation Specialist opportunity with one of our clients in Mason, OH

Position Details:

Work Location Cincinnati service centre 4000 Mason, OH 45040

Job Title Operation Specialist

Duration 6 months (with high possibility of extension)

Job Description:

The QA Ops Specialist leads the resolution of member and provider complaints and appeals related to quality of care, access to care and benefit determination.

•Work collaboratively with other departments including customer care, claims, and legal to investigate and resolve member complaints and appeals.

•Develops formal request and response letters and written summaries of cases including the facts of the case, resolution, and directions regarding provider education or actions.

•Provides monthly, quarterly and annual reporting to QA committee and clients regarding complaints and appeals to ensure compliance with performance guarantees.

Category:IT code:new

Area Code

45040

Job Requirements

Education

•High School Diploma/GED

•2+ years claims processing or vision benefits and product experience

•Bachelor’s degree in Business related disciplines

Preferred Skills: