Adjudication Analyst

Customer Support:

-Serve as customer support to internal stakeholders to provide front-line technical and analytical resolution on the SmithRx adjudication platform.

-Address planned and unplanned escalation issues related to adjudicated claims and data sharing inquiries

-Perform troubleshooting of all mission-critical adjudication issues to triage and resolve issues in a timely manner.

Data Analysis & Collaboration:

-Perform in depth analysis of claims data inconsistencies and develop output reports detailing resolution and data validation

-Partner closely with Plan Operations and Account Management organizations to ensure that all of their data-related needs are met

-Collaborate with business partners and engineering to create streamlined processes for customer issue resolution

Testing:

-Conduct User Acceptance Testing on software solutions and enhancements