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MAJOR RESPONSIBILITIESThe Analyst, ROC Product is responsible for supporting the ROC team through obtaining, analyzing and communicating information that provides insight in the development of new products. The incumbent will be instrumental in the execution of product strategy with data driven and customer oriented focus. The incumbent will have internal and external client interactions to obtain validation and input into current development initiatives. The incumbent will create insights that drive the direction of the company - identifying product opportunities, understanding experiment performance, and defining metrics for the business.- Collaborate with internal and external stakeholders to gather requirements and map, structure, document, and validate technical requirements for new or enhanced ROC products.- Research, document, and disseminate information of product industry and competitor trends, features, and news.- Create documentation including process diagrams, use cases, business, functional, and non-functional requirements; developing use cases and functional requirements for features development.- Analyze and audit claims submitted by the billers to identify inconsistencies.- Ensure all claims submitted meet the consistency and quality standards of the company.- Analyze Explanation of Benefits (EOB) statements and adjust accounts according to PDS claims processing criteria.- Perform daily activities of auditing patient claims billed to ensure accurate and maximum reimbursement for patient treatment from insurance carriers.- Analyze and communicate key insights for existing projects and act as a thought leader and subject matter expert for specific business problems.- Monitor key performance metrics and understand root causes of change.- Report weekly to Sr. Manager of Billing Operations detailing accomplishments, areas for improvement, clear performance goals, and effectiveness of existing processes and systems.- Other duties as assigned by management.REQUIRED:- Bachelor-s Degree in Business Management or a related field. In lieu of degree, +4 years- of experience is required or the equivalent combination of education and experience.- 4-6 years- of related experience in product analysis, dental or medical billing operations.- Knowledge of QSI software applications.PREFERRED:- Experience in a multi-regional healthcare, retail, or dental company.- Ability to read and interpret EOBs (Explanation of Benefits).- Prior customer service experience.KNOWLEDGE/SKILLS/ABILITIES:- Ability to multi-task effectively without compromising the quality of the work.- Excellent interpersonal, oral and written communication skills.- Detail oriented, organized, process focused, problem solver, proactive, ambitious, customer service focused.- Ability to draw conclusions and make independent decisions with limited information.- Ability to respond to common inquiries from customers, staff, regulatory agencies, vendors, and other members of the business community.- Self-motivated, reliable individual capable of working independently as well as part of a team.- Problem solving skills to gather & analyze information in order to identify and resolve problems in a timely manner arrive at valid conclusions, recommendations, and plans of action.- Analytical skills to synthesize complex or diverse information. Ability to research information and analyze data to arrive at valid conclusions, recommendations, and plans of action.- Actively share ideas in a constructive and positive manner by listening to and objectively considering ideas and suggestions from others.- Excellent analytical, quantitative and problem-solving skills and strong attention to detail business correspondence and business reporting techniques; and business principles.- Knowledge of dental office management and operations, as well as knowledge of best practices in dental for front office personnel.
Location : External NameNational Support Center