Technical Research Specialist

Position Code: 9974

Department:  Quality Assurance
Location: Nashville, Tennessee
Immediate Supervisor:  Tracie Brown
Status: Non-Exempt
Posted: August 14 2017

Essential Functions of Job:

• Test new groups prior and during implementation • Test plan changes for all groups at renewal • Participate on implementation calls with the client, account management and benefit programming departments • Ability to work closely with account management, benefit programming, PBM team and IT Departments to validate data loads, accumulators, duplicate history and customer service history as needed • Perform and complete testing in test directories as provided in the IQ • Review IQ against the prior SPD when attempting to duplicate prior benefits • Troubleshoot and resolve all outstanding issues with new group • Responsible for all documentation related to testing and final results • Additional responsibilities will include: o Review autopay results and select groups with low percentages for improvement opportunities o Monitor and Test new processes and HAXS changes o Participate in the testing, development and/or implementation of new products o Test new autopay rules, EOB comments, processing changes prior to processing in live accounts o Cross train within QA department in order to perform jobs interchangeably • Ability to report to the office

Qualifications:

• High school diploma or equivalent • Effective organizational and prioritization skills • Excellent oral and written communication skills • Basic knowledge of Microsoft Office software applications (Word, Excel, Outlook, Access) • Ability to work in a fast paced multi-tasking environment • Strong interpersonal skills with ability to function as a positive team member • Superior skills in benefits interpretation • Strong mathematical background • Experience with Healthaxis system desired • 2-3 years experience in processing medical, dental and/or vision claims preferred • Keeps abreast of the current URAC Standards as they apply to this position

 

The Company considers applicants without regard to race, color, national origin, sex, religion, mental or physical disability, marital status, age 40 years and over, sexual orientation or gender identity, veteran's status, or other characteristic protected by applicable law.

Applications for this vacancy will be received for 3 working days after the Posted date from Employees of HealthSCOPE Benefits with more than one year of service.

Applications for this vacancy will be received for 10 working days after the Posted date from External Applicants.