Mitchell International, Inc. is a leading provider of information and workflow solutions to the Property & Casualty Claims Industry and their supply chain partners. We solve interesting and complex problems that directly affect the customers our clients serve. We are constantly adapting to stay on the forefront of emerging technologies and we work diligently to maintain our position as a thought leader within our industry.
Mitchell’s worker’s compensation national managed care program offers solutions for insurance carriers, third-party administrators and employers. We recommend an integrated suite of solutions that include utilization review and case management with a focus on managing total claims costs while expediting safe return to work.
Our applications provide our clients with state specific and customizable edits to complement our Electronic Data Interchange (EDI) solutions for billing, injury reporting, and Centers for Medicare & Medicaid Services (CMS). Our solutions allow claims administrators ease in management while meeting today's regulatory compliance standards and meeting our client’s operational efficiency goals.
This position will document issues in SalesForce CRM and triage incoming customer problem calls and emails. They will resolve or escalate the issue to the appropriate team. The analyst role also ensures our SLA obligations are being met on a client by client basis. They will partner directly with clients and configure system settings and options, plan and implement changes, etc. In addition, the Analyst will analyze state-specific mandatory, conditional edits and IAIABC business edits for FROI/SROI. Analyst will proactively monitor EDI and file transactions to ensure compliance with internal and state SLAs. Analyst will provide an exceeded level of customer service and technical expertise both internally and to the client in identifying, troubleshooting, and resolving issues. The right match will have the ability to work independently, in a team setting, and also directly with clients to drive the successful resolution of issues.
Education: BA/BS + 2-3 years of experience.
Prior Experience: IAIABC or FROI/SROI industry experience is highly recommended.
Strong understanding or related experience in a support type setting with the following:
o ANSI file formats
o First Reports of Injury (FROI) and Subsequent Reports of Injury (SROI)
o IAIABC Edits.
Demonstrated knowledge of system integration, thin and thick client utilization, troubleshooting configuration conflicts, data communication, etc.
1-2 years WorkComp/Medical experience required
Strong understanding of third party component integration.
Proven skills in handling multiple tasks or projects and ability to dynamically prioritize.
Healthcare/Workers' Compensation billing experience a plus.
Written Abilities: Proficient grammar, sentence structure, and written communication skills.
Technical Experience: Proficiency in editing data files, XML, Microsoft Office Suite, SalesForce.com, and SharePoint are recommended.
Working Conditions/Physical Requirements: - Based out of the Irvine California Office or can work remotely from anywhere in the U.S.