
Business Operations Specialist
2 days ago
Job Title: Business Operations Specialist
">We are seeking an experienced Business Operations Specialist to join our team.
Key Responsibilities:- Governance and Compliance
- Analyze and document business requirements related to HIPAA, CMS, NCQA, and state-specific regulations.
- Evaluate system changes, processes, and documentation for compliance with healthcare regulations and payer guidelines.
Benefits include medical, dental, pharmacy, and specialty products. The ideal candidate will have experience in benefit code analysis and configuration, as well as plan design and validation in healthcare systems (e.g., Facets, QNXT, or other payer platforms).
- Plan Administration
- Collaborate with product and IT teams to ensure accurate coding, claims adjudication, and eligibility processing.
We require a strong understanding of regulatory requirements and the ability to analyze complex data. Additionally, excellent communication and project management skills are essential for this role.
About the Role:
This is a challenging opportunity to work in a dynamic environment, driving process improvements and ensuring regulatory compliance. If you are motivated and enthusiastic about business operations, we encourage you to apply.
Contact Information:
Please submit your application, including your resume and cover letter, to us through the designated portal.
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