Group Control Analyst

The Underwriting Department plays an integral role in supporting the financial "bottom line" for Blue Cross and Blue Shield of Alabama. Its role is to establish appropriate premium rates and administrative fee levels for all customers based on the benefit levels selected. This is achieved through sound pricing, rating techniques, and trend analysis. Underwriting works closely with the Marketing Department to support sales efforts and to recommend benefit options that maintain financial viability for the customer. Underwriting also ensures timely and accurate groups setup and maintenance as well as providing reporting and other data.

The incumbent is responsible for verifying group Enrollment Agreements, Change Agreements, and other legal documents (e.g. Business Associate Agreement, Designated Plan Sponsor, Designation of Third Party Administrator, Confidentiality Agreement, etc.), resolving rate and benefits issues, maintaining approved protected health information (PHI) contacts, assigning coverage codes and data coding used in financial forecasting and reporting, posting and maintaining applicable rates and administrative fees used in customer billing, maintaining internal and external contact information, and documenting membership eligibility rules. The incumbent is also responsible for the timeliness and accuracy of all information on GEMS, which is vital to member eligibility, group billings, adjudication of claims, reporting systems, ID card issuance, and ultimately to ensure timely and quality customer service. Additionally, the incumbent must remain abreast of the latest changes and guidelines impacting the area including federal and state mandates, new product development, new technologies, etc.

• Bachelor's Degree
• Working knowledge of claims processes, customer enrollment, customer billing, or customer service, etc.
• Experience in a position interpreting and communicating information, orally and written
• Experience in a position communicating with internal and external customers, including working with associates and management at all levels
• Experience in a position researching and analyzing data and presenting recommendations
• Experience in a position organizing and prioritizing multiple tasks
• Experience in a position requiring close attention to detail
• Experience in a positions exercising independent judgment and decision making
• Experience in a position meeting strict timeliness deadlines and accuracy goals
• Microsoft Office proficiency, including Excel
• Experience facilitating/leading meetings
• GEMS knowledge preferred
• Demonstrate business acumen regarding departmental and corporate strategic initiatives preferred
• Experience reviewing group files preferred
• Experience interpreting legal documents and a benefit matrix preferred
• Experience with underwriting preferred
• Experience utilizing mathematics or statistics preferred
• Experience communicating with Information Technology (IT), Sales and Marketing departments preferred
• Experience working in or with Marketing/Sales, Enrollment, Billing or Claims preferred

The work location for this position will be hybrid (onsite/remote)

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We appreciate your interest in Blue Cross and Blue Shield of Alabama 'The Company'. The Company does not discriminate in hiring or employment on the basis of race, color, religion, creed, sex, sexual orientation, gender identity, national origin, age, disability, genetics, status as a disabled or protected veteran, or because of citizenship status in the case of a citizen or intending citizen. No question on this application is intended to secure information to be used for such discrimination.
Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association