Benefits Assurance Analyst
An ASEBP Benefit Analyst is tasked with working to make certain claims from across all lines of benefits offered by ASEBP are submitted and adjudicated as per the plan documents and service agreements, as well as being free of fraud and abuse. Utilizing an anonymous tip line, routine monitoring and advanced analytics the Benefit Analyst role works to ensure continued viability of ASEBP’s benefit plans.
Your Key Responsibilities
- Facilitate the protection of the benefit plan from fraud and abuse of covered members and/or providers through advanced analytic reviews, routine claims monitoring and continued development of Benefit Assurance
- Work internally, and with external partners, to identify, assess, investigate, report on, and resolve areas of benefit fraud and abuse and errors in adjudication.
- Manage ASEBP’s tip line and internal contacts, collecting information for analysis and the formal investigation of claiming concerns.
- Implement detective and preventative controls aimed at minimizing the potential for fraud and abuse within ASEBP’s benefit plan.
- Conduct claims confirmation projects with covered members asking them to verify various aspects of their claimed products/services, tracking the responses, investigating when required and reporting accordingly.
- Support ASEBP’s fraud awareness initiatives internally and externally with covered member and employer group education on benefit fraud and abuse.
Your Education and Experience
- Three to five years of related experience.
- Strong computer skills in Microsoft Office.
- Knowledge of fraud and legal rights and expectations is considered an asset.
A combination of education and experience may be considered.
- Proficient knowledge about benefit administration to understand complexities in patterns to identify and investigate.
- Ability to effectively and comfortably explore difficult and complex issues, and provide information, alternatives or suggestions.
- Good decision making and problem solving skills.
- Ability to work well in a fast paced environment, while maintaining a high attention to detail.
- Strong communication skills.
How To Apply
If you have the required qualifications and would like to become a member of our team, please submit your resume by 4PM on Friday, January 21, 2022.
This position is currently working from home and will be eligible to participate in the hybrid workforce program when the office reopens.
No phone calls please. We thank all interested individuals, but only those candidates being considered for an interview will be contacted. ASEBP is an equal opportunity employer.
All offers of employment for this position are conditional upon satisfactory background and reference checks, which may include a criminal record check, and/or education and employment verification.