Administrative Analyst

Join Our Team as an Administrative Analyst

American Specialty Health Incorporated (ASH) is looking for an Administrative Analyst to support our Medical Necessity/Benefits Administration department. In this role, you will be responsible for generating, mailing, and tracking member service denial notifications in line with industry standards.

About the Role

This position is fully remote, allowing you to work from home with company-provided technology. You will need a stable internet connection to participate in video meetings. Your main focus will be on ensuring compliance with URAC, NCQA, CMS, DMHC, and ASH standards.

What You'll Do

• Generate and mail member service denial notifications to members, health plans, and practitioners.
• Develop and maintain procedures related to member service denial processes.
• Revise service denial letters and matrices as required by various regulatory bodies.
• Coordinate workflow with MNA and CQE to ensure notifications are sent appropriately.
• Enter necessary information in the system to track service denial notifications.
• Create and submit member service denial logs to contracted health plans regularly.
• Report and track service denial notification turnaround times.
• Ensure compliance with turnaround time standards.
• Maintain confidentiality of all member, provider, client, and proprietary information.
• Provide administrative support and assist with special projects as needed.
• Prepare files for audits and run system queries and reports.
• Perform other duties as assigned and comply with all policies and standards.

What We're Looking For

• High School Diploma or GED certificate required.
• 2 years of progressive experience in administrative duties, with internal experience at ASH preferred.
• Proficiency in MS Word, Excel, and Access.
• Knowledge of CMS and DMHC regulations is helpful.
• Strong analytical and written communication skills.
• Ability to interact positively and respectfully with others.
• Excellent customer service skills to meet the needs of internal and external customers.
• Strong organization, prioritization, and time management skills.
• Ability to maintain accuracy and productivity in a changing environment.
• Ability to analyze information and develop effective solutions.
• Commitment to confidentiality in all matters.

Nice to Have

• Familiarity with healthcare regulations and standards.

What We Offer

We offer a competitive hourly wage ranging from $16.36 to $17.00, depending on your qualifications, education, skill set, and experience. You will also enjoy the flexibility of working from home, provided you have a reliable internet connection with a minimum speed of 50 down/10 up Mbps (100 down/20 up is recommended).

American Specialty Health is committed to creating a diverse and inclusive workplace. We welcome applicants from all backgrounds and will provide accommodations to individuals with disabilities during the hiring process. If you need assistance, please contact our Human Resources Department at (800) 848-3555 x6702.

We look forward to hearing from you!