POSITION SUMMARY
The Senior RRT Analyst will be responsible for reviewing the incoming referrals daily to determine priority and distribute team assignments. The Senior Analyst will run reports from Allied’s website for special projects that are received within the department to determine adjustments needed and assign accordingly. Provide training to the team as needed. The Senior RRT Analyst will also be responsible for managing Blue Cross Blue Shield (BCBS) and Anthem adjustments.
ESSENTIAL FUNCTIONS
- Work with other departments when necessary to determine appropriateness of an RRT referral.
- Manage the BCBS and Anthem process, including adjustments and closing claims in the BCBS systems.
- Tracking and handling of projects timely
- Update member accumulators and complete adjustments as necessary
- Maintain department workflows for RRT processes
- Handle tasks assigned to RRT such as high dollar split claims, repricing adjustments, and group exception referrals
- Run web reports for special projects
- Support other units within Claim Operations
- Support Refund process when needed
- Other related duties as assigned
EDUCATION
- High school diploma or equivalent required
EXPERIENCE AND SKILLS
- Applicants must have 5+ years of comprehensive experience with adjustment processing
- Applicant must be proficient at the use of Microsoft Word and Excel programs and can easily learn other data systems.
POSITION COMPETENCIES
- Accountability
- Analytical Thinking
- Collaboration
- Communication
- Customer Focus
- Functional Expertise
- Initiative
PHYSICAL DEMANDS
- This is a standard desk role that requires extended periods of sitting and computer work
WORK ENVIRONMENT
- Remote
Here at Allied, we believe that great talent can thrive from anywhere. Our remote friendly culture offers flexibility and the comfort of working from home, while also ensuring you are set up for success. To support a smooth and efficient remote work experience, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 100Mbps download/25Mbps upload. Reliable internet service is essential for staying connected and productive.
The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills, and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.
Compensation is not limited to base salary. Allied values our Total Rewards, and offers a competitive Benefit Package including, but not limited to, Medical, Dental, Vision, Life and Disability Insurance, Generous Paid Time Off, Tuition Reimbursement, EAP, and a Technology Stipend.
Allied reserves the right to amend, change, alter, and revise, pay ranges and benefits offerings at any time. All applicants acknowledge that by applying to the position you understand that the specific pay range is contingent upon meeting the qualification and requirements of the role, and for the successful completion of the interview selection and process. It is at the Company's discretion to determine what pay is provided to a candidate within the range associated with the role.
Skills Required
- High school diploma or equivalent
- 5+ years of comprehensive experience with adjustment processing
- Proficiency with Microsoft Word and Microsoft Excel
- Reliable cable broadband or fiber internet with at least 100Mbps down / 25Mbps up for remote work
What We Do
Allied is a national healthcare solutions company that works with organizations who choose to take control of their healthcare. We customize employer self-insurance benefits to align with individual choice and organizational need while integrating medical management innovations and cost-control strategies. With healthcare designed for people, employers never have to choose between price and the best-fit insurance products to protect employees and their families. Allied’s philosophy is to create a culture of health for our member organizations and their employees beyond simple, medical health. We integrate administrative services, care solutions and analytics to achieve better clinical, behavioral and social patient outcomes. Allied’s programs and benefit services are designed and structured to infuse value on every front – for employers and HR departments, for plan members and their families, for healthcare providers, and for us. We’re in this together, committed to your future.
