Health/Medical Plans Claims Audits and Analytics Consultant

Benz Communications (Inactive)

NY(remote)

JOB DETAILS
SALARY
$101,500–$130,000 Per Year
SKILLS
Actuarial Skills, Administrative Skills, Analysis Skills, Auditing, Business Development, Business Growth, Business Strategy, Competitive Analysis/Strategy, Consulting, Cross-Selling, Customer Relationship Management (CRM), Customer Service Management, Data Analysis, Employee Benefits, Government, Health Plan, Higher Education, Human Resources, Interpersonal Skills, Investment Management, Leadership, Management Consulting, Marketing Strategy, Microsoft Excel, Microsoft Outlook, Microsoft PowerPoint, Microsoft Product Family, Microsoft Word, Multitasking, Organizational Development/Management, Plan Meetings, Pricing, Problem Solving Skills, Profit & Loss, Project Development, Project Planning, Project/Program Management, Proposal Writing, Request for Proposals (RFP), Resolve Customer Issues, SQL (Structured Query Language), Technical Analysis, Time Management
LOCATION
NY
POSTED
30+ days ago

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Are you passionate about delivering trusted advice that improves lives?

Come work with us!

Our Consultant, Health/Medical Benefits Claims Audits and Analytics has responsibility for leading health/medical benefits claims audits and analyses for our clients.

Key Responsibilities:

  • Perform as the lead health/medical claims audit consultant and/or CRM to clients.

  • Provide strategic and business-oriented consulting advice on claims auditing practices and results, serving as counsel to clients and internal staff.

  • Conduct planning meetings to identify/define client needs/issues and develop project plans and approaches that are responsive to client needs.

  • Conduct technical analyses and quality reviews. Formulate conclusions and deliver client recommendations.

  • Build and maintain effective rapport internally and with senior management in client organizations, vendors, and internally within the Company.

  • Manage projects within scope, profitability and productivity targets.

  • Lead business growth strategies and marketing initiatives to assist business development and cross-selling efforts.

  • Respond to Requests For Proposals (RFPs) including preparing written proposals, providing pricing information, and defining project scope recommendations.

  • Gather, use and share market intelligence to develop and introduce unique and/or new approaches to servicing clients.

'',''!*!

Are you passionate about delivering trusted advice that improves lives?

Come work with us!

Our Consultant, Health/Medical Benefits Claims Audits and Analytics has responsibility for leading health/medical benefits claims audits and analyses for our clients.

Key Responsibilities:

  • Perform as the lead health/medical claims audit consultant and/or CRM to clients.

  • Provide strategic and business-oriented consulting advice on claims auditing practices and results, serving as counsel to clients and internal staff.

  • Conduct planning meetings to identify/define client needs/issues and develop project plans and approaches that are responsive to client needs.

  • Conduct technical analyses and quality reviews. Formulate conclusions and deliver client recommendations.

  • Build and maintain effective rapport internally and with senior management in client organizations, vendors, and internally within the Company.

  • Manage projects within scope, profitability and productivity targets.

  • Lead business growth strategies and marketing initiatives to assist business development and cross-selling efforts.

  • Respond to Requests For Proposals (RFPs) including preparing written proposals, providing pricing information, and defining project scope recommendations.

  • Gather, use and share market intelligence to develop and introduce unique and/or new approaches to servicing clients.

'',''!*!

  • 6+ years of health/medical claims audit and/or administration experience to include significant exposure to and expertise in electronic audit functions to include systems and tools relevant to an independent/third-party audit process; experience leading efforts to achieve revenue and/or profitability-oriented objectives; actuarial experience valued.

  • Undergraduate degree. Advanced degree preferred.

  • Proficiency in Microsoft suite of products (i.e., Word, Excel, PowerPoint, and Outlook).

  • Data analysis expertise to include familiarity with SQL and Excel macros highly preferred.

  • Project management and client servicing/relationship management skills.

  • Effective interpersonal and relationship building skills with ability to build rapport with diverse audiences.

  • Proficiency in writing and oral presentation. Strong ability to problem solve, multi-task and manage multiple deadlines.

Join Segal:

If your qualifications align closely with what we have described, we encourage you to apply. Your unique background and skills matter because at Segal, we believe that different experiences and perspectives drive innovation and excellence. We are committed to creating a fair and transparent hiring process and all hiring decisions will be merit driven. If you require accommodation during the interview, please let us know. Thank you for considering Segal. We are excited to learn more about you!

About Segal and its Total Rewards Program:

Segal is a privately owned, leading North American employee benefit, human resources and investment management consulting firm with over 80 years of history providing trusted advice that improves lives. Clients include public and private corporations, multiemployer trust funds, public sector entities, higher education institutions, institutional advisors, among many others.

Segal's total rewards are part of what makes Segal a special place to work. The current salary range for this position is $101,500 - $130,000.

#LI-Remote

'',''!*!

  • 6+ years of health/medical claims audit and/or administration experience to include significant exposure to and expertise in electronic audit functions to include systems and tools relevant to an independent/third-party audit process; experience leading efforts to achieve revenue and/or profitability-oriented objectives; actuarial experience valued.

  • Undergraduate degree. Advanced degree preferred.

  • Proficiency in Microsoft suite of products (i.e., Word, Excel, PowerPoint, and Outlook).

  • Data analysis expertise to include familiarity with SQL and Excel macros highly preferred.

  • Project management and client servicing/relationship management skills.

  • Effective interpersonal and relationship building skills with ability to build rapport with diverse audiences.

  • Proficiency in writing and oral presentation. Strong ability to problem solve, multi-task and manage multiple deadlines.

Join Segal:

If your qualifications align closely with what we have described, we encourage you to apply. Your unique background and skills matter because at Segal, we believe that different experiences and perspectives drive innovation and excellence. We are committed to creating a fair and transparent hiring process and all hiring decisions will be merit driven. If you require accommodation during the interview, please let us know. Thank you for considering Segal. We are excited to learn more about you!

About Segal and its Total Rewards Program:

Segal is a privately owned, leading North American employee benefit, human resources and investment management consulting firm with over 80 years of history providing trusted advice that improves lives. Clients include public and private corporations, multiemployer trust funds, public sector entities, higher education institutions, institutional advisors, among many others.

Segal's total rewards are part of what makes Segal a special place to work. The current salary range for this position is $101,500 - $130,000.

#LI-Remote

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Chicago (CHI)

101 North Wacker Drive, Suite 1800

Chicago, 60606

Phoenix (14)

1501 W Fountainhead Pkwy, Suite 370

Tempe, 85282

Boston (15)

116 Huntington Avenue, Suite 901

Boston, 02116

Washington DC (12)

1800 M Street NW, Suite 900 S

Washington, 20036

Los Angeles (23)

10880 Wilshire Boulevard,Suite 850

Los Angeles, 90024

San Francisco (13)

180 Howard St, Ste 1100

San Francisco, 94105

Houston (26)

7900 N. Sam Houston Pkwy W, Suite 110

Houston, 77064

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About the Company

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Benz Communications (Inactive)