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· Health insurance background

· Claims and Enrollment background plus

· Trizetto- a plus not required

· Must have the ability to document SOPS

· Information mapping skills a plus

Requirements:
* Bachelors Degree
* 3-5 years related experience with a focus in research, report writing and documentation required.

Responsibilities:
* Develop clear and concise messages to convey information /explanations to providers/provider offices and members regarding claims status, claims adjudication actions, member benefits and eligibility.
* Translate current “in-house” terminology into easily understood messages
* Conduct internal interviews to obtain necessary information
* Coordinate review and approval process with internal and external interested parties, including Legal, Corporate Communications, Physician and Provider Advisory groups
* Ensure messages comply with any applicable regulatory requirements.