Analyst III - Issue Management

What Will Be Your Purpose

Support the enterprise with highly engaged, solutions driven team(s) that applies a cost effective consistent approach to the resolution of complex issues. The analyst's role supports applying analytical knowledge and skills as an exempt-level individual contributor to resolving issues and getting to root cause decreasing medical and administrative expense.

What Will You Do

• Obtains and analyzes data to resolve complex provider issues. Research to determine root cause, develops business requirements and problem statements, and monitors and communicates final results in accordance with PE established guidelines.
• Produces basic, standard and ad hoc reports typically used in reprocessing claims, issue resolution, and trending.
• Supports projects, including assisting in researching and providing support for business rules, user requirements, and other project related documentation
• Leads segments of larger projects.
• Perform other duties as assigned

What You Must Have

• 3+ years related work experience or equivalent combination of transferable experience and education in issue root cause analysis
• Related Bachelor's degree or additional related equivalent work experience
• Experience utilizing corporate systems Diamond, Quest, Siebel and Service Manager
• Knowledge of claims adjudication processes and claim processing systems
• Proficient with Microsoft Applications: Word, Excel and PowerPoint
• Experience with query development

What We Prefer

• Experience resolving complex provider issues
• Experience working with Florida Blue supporting systems (i.e., EIP, Diamond payment, ITS, PeopleSoft, Siebel, PAIS, JIVA, PIMS, RBMS, PCM, Legacy, Blue Squared, Claims Repository and pricing files )

General Physical Demands

• Exerting up to 10 pounds of force occasionally to move objects.
• Jobs are sedentary if traversing activities are required only occasionally.

We are an Equal Opportunity/Protected Veteran/Disabled Employer committed to creating a diverse, inclusive and equitable culture for our employees and communities