Senior , Eligibility Analyst

Teladoc Health is a global, whole person care company made up of a diverse community of people dedicated to transforming the healthcare experience. As an employee, you’re empowered to show up every day as your most authentic self and be a part of something bigger – thriving both personally and professionally. Together, let’s empower people everywhere to live their healthiest lives.

Summary of Position

Under the direction of the Director, Technical Eligibility, the Senior Eligibility Analyst will work on key revenue impacting processes within the Teladoc business model. Their responsibilities will include researching, analyzing data, and maintaining accuracy within the member database. Work will be measured by the achievement of business objectives and progress towards strategic goals leading to improved productivity or profitability. 

Essential Duties and Responsibilities

·       Develop an understanding of medical data feeds, including Medical/Provider Claims Data, Pharmacy Benefit Management/Pharmacy Claims, and similar clinical evidence data

·       Work with technical and non-technical client stakeholders to explain data concepts and enforce data requirements

·       Establish strong relationships with partners and clients with a goal of standardizing data file templates and operations

·       Collaborate with Product, Reporting, Clinical, Data Operations and Engineering teams on developing data-driven solutions

·       Ensure quality and integrity of our data through both manual querying and automated templates

·       Develop various dashboards using our internal data visualization tools, Metabase and Power BI

·       Perform root cause analysis on client or member issues leveraging multiple internal systems

·       Resolve eligibility inquiries and effectively communicate outcomes to other departments while keeping to established timelines 

·       Review and correct eligibility data in Teladoc’s records, ensuring accuracy 

·       Assist with training and onboarding of new hires 

·       Participate in internal audit processes

·       Act as a Subject Matter Expert on internal and client-facing calls as needed 

·       Maintain knowledge of industry standards for eligibility verification

·       Understand and adhere to HIPAA policies, procedures, and regulation, maintaining strict confidentiality 

Must access PHI/PII ​

The time spent on each responsibility reflects an estimate and is subject to change dependent on business needs. 

Supervisory Responsibilities

No

Qualifications Expected for Position

• 1 – 3 years experience with data processing and analytics
• 1 – 3 years experience with working with healthcare data
• Strong SQL skills (MSSQL, MySQL, PostreSQL, Redshift)
• Advanced excel skills 
• Critical attention to detail 
• Comfort and success working in a fast-paced environment with tight deadlines 
• A proactive approach to identifying and resolving issues 
• Strong communication, project management, and organizational skills
• Data warehousing and ETL experience
• Experience developing and maintaining operational processes
• Degree in Computer Science, Information Systems or a related field

Required license or credential n