Operations Senior Advisor Government Programs
CurrentLead claims fulfillment operations support and delivery for paper and electronic member and provider documents. Key templates include Explanation of Benefits (EOBs) Explanation of Payments (EOPs) and Integrated Denial Notices (IDNs). Serve as business SME for template enhancements, Center for Medicare and Medicaid Services (CMS) compliance initiatives, and other benefit related requirements.Direct contact and stakeholder liaison for benefit, template, design, filing, translation enhancements and issue analysis and resolution. Key customer stakeholder support groups include Treasury, Accounts Payable, Finance, Member Materials, Medicaid Operations, Network Operations, Provider Data Management, QNXT IT Development, Claim Operations, PeopleSoft, Appeals, and Customer Service.
