The Operations Analyst (MMC Operations Associate) performs operational tasks required by GRG Medical Monitoring and Consulting programs. This includes daily performance of tasks associated with appointment management, claims processing, systems administration and testing, reporting, and provider call center staffing.
Responsibilities and Duties
Claims Administration – Accurately and efficiently performs claim intake, adjudication, payment, and generation of provider and class member correspondence (e.g., explanation of payment and explanation of benefits).
Program Liaison – Liaison with GRG’s Claimant Service Center – Serves as a liaison to the Call Center to support coordination of program administration.
Inquiries – Responds to class member inquiries in a timely, effective, and accurate manner.
Document Management – Manages document storage and maintenance for all operational activities.
Provider Services Phone Line – Manages the incoming calls for the Provider Services Phone Line efficiently and fulfills all phone queue support obligations.
Claims Software Application – Serves as subject matter expert for all claims-related software applications.
Claims/Financial Reporting and Appointment Reporting – Generates required program reports accurately and on-time.
Software User Acceptance Testing – Participates in user acceptance testing under the direction of the MMC Operations Manager.