Angle Health

Health Insurance for Startups

Operations Analyst

Location
Remote / Remote
Job Type
Full-time
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Anirban Gangopadhyay
Anirban Gangopadhyay
Founder

About the role

A Life-Changing Company

At Angle, we believe the healthcare system should be accessible, transparent, and easy to navigate. As a digital-first, data-driven health plan, we are replacing legacy systems with modern infrastructure to deliver our members the care they need when they need it. If you want to change the future of healthcare, we'd love for you to join us.

The Role

The Operations Analyst is responsible for ensuring health plan data is entered and managed timely, accurately, and adheres to compliance and regulatory requirements. The Operations Analyst is a cross-functional position that includes claim processing and resolution, configuration, enrollment, credentialing, and provider data management.

Enrollment

  • Assemble, review, and complete welcome/enrollment packets for new enrollees
  • Reconcile member and group enrollment transactions between broker and internal systems
  • Coordinate with Operations Center to accurately and timely respond to inquiries regarding member and group enrollment
  • Complete quality audits on enrollee data, completing the necessary outreach to resolve any findings
  • Initiate coordination of benefits (COB) questionnaires and update enrollment records to ensure primary, secondary, and tertiary coverages are configured under NAICS guidelines and performing any necessary outreach to other insurance payers
  • Research vendor platforms to identify and troubleshoot enrollment issues (IE: pharmacy, vision, etc.)
  • Process returned mail, identifying alternative addresses and making appropriate system updates

Provider Data/Configuration

  • Update internal systems with new provider demographic information upon contract execution
  • Configure internal claim systems to custom provider fee schedules that align with executed agreements; performing necessary testing and troubleshooting
  • Ensure the data loads meet quality standards and participate in testing and audit activities related to data integrity and accuracy
  • Ensure organized storage of all relevant provider documents and contracts
  • Interact with provider offices to verify updates to provider information
  • Assist with provider education efforts on contract status inquiries
  • Participate in any testing and validation of system changes and improvements
  • Develop and maintain standards for database integrity and quality assurance

Credentialing

  • Outreaches to providers immediately upon notification of CVO fallout and/or failure to contact
  • Identifies improvement opportunities and recommends enhancements and workable solutions
  • Provides telephonic and written education to providers on credentialing policies and procedures
  • Identifies and communicates trends (quality of results, efficiencies of processes) with management
  • Directly contacts providers/producers and/or outside entities to clarify data quality issues
  • Provides issue resolution for providers/producers, during the credentialing or data management processes
  • Perform data entry and systems maintenance as needed; align data across systems
  • Ongoing license Sanction monitoring and reporting to minimize corporate risk

General

  • Understand department, segment, and organizational strategy and operating objectives, including their linkages to related areas
  • Provide feedback on system limitations or expansion needs to reduce errors and improve processes
  • Participates in system testing and communicates newly-identified and potential issues to management.
  • Process ad-hoc reporting requests
  • Attend and actively participate in daily, weekly, and monthly departmental meetings, training and coaching sessions
  • Maintain productivity and quality standards as defined by management
  • All other related duties, as assigned

What We Value

  • Bachelor’s Degree in Healthcare Administration, Business, or related education
  • 1-3 years of experience working with commercial or federal health insurance payer
  • Highly proficient in Microsoft Word and Excel, including the ability to manipulate large sets of data and use formulas
  • Ability to effectively coordinate, manage multiple assignments, and prioritize work in a fast-paced environment
  • Knowledge of medical terminology, ICD-10, and CPT coding
  • Mathematical aptitude and analytical skills
  • Ability to research and investigate information using available resources
  • Strong interpersonal skills
  • Strong analytical, comprehension, decision-making, and problem-solving skills
  • Excellent listening, verbal, and written communications skills
  • Ability to identify and adhere to state-specific (Utah) regulatory requirements

Bonus Points

  • 1-3 year of experience with Virtual Benefits Administrator (VBA)
  • 1-3 years of credentialing and/or auditing experience for a health payer or provider
  • Knowledge of TJC, NCQA, CMS, DHS, DMHC, ACGME and other applicable accreditation/regulatory requirements
  • CPC, COC, CIC, CRC, or other medical coding certification
  • Knowledge of different providers’ payment methodologies (i.e., capitation, fee-for-service, value-based, other negotiated flat rates, RVS pricing, Per Diem, DRG pricing, etc.)
  • Proficient with SQL and data analytics tools for reporting, writing queries, and data analysis
  • Proficient with reviewing, testing, and configuring fee schedules for commercial products
  • Experience with procedure documentation and writing policies to meet state and/or federal requirements
  • Experience and familiarity with CAQH VeriFide

Because We Value You

  • Competitive compensation and equity packages
  • Comprehensive health, vision & dental insurance
  • Unlimited paid time off
  • Opportunity for rapid career progression
  • Relocation assistance (if relocation is required)

Backed by a team of world class investors, we are a healthcare startup on a mission to make our health system more effective, accessible, and affordable to everyone. From running large hospitals and health plans to serving on federal healthcare advisory boards to solving the world's hardest problems at Palantir, our team has done it all. As part of this core group at Angle, you will have the right balance of support and autonomy to grow both personally and professionally, and the opportunity to own large parts of the business and scale with the company.

Angle Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Angle Health is committed to working with and providing reasonable accommodations to applicants with physical and mental disabilities.

Why you should join Angle Health

At Angle Health, we're tackling the healthcare crisis at the point where our health system starts and stops: health insurance. By building a modern, technology-driven health plan, we are creating a customer-centric experience that gets our members the care they need when they need it. We're on a journey to making people healthier and we're starting with startups. If you want to be part of the future of healthcare, we'd love for you to join us.