About Avalon Healthcare Solutions:

Avalon Healthcare Solutions is the world's first and only Lab Insights company, bringing together our proven Lab Benefit Management solutions, lab science expertise, digitized lab values, and proprietary analytics to help healthcare insurers proactively inform appropriate care, reduce costs, and improve clinical outcomes. Working with health plans nationwide, the company covers over 44+ million lives and delivers 10-20% proven outpatient lab benefit savings. Avalon is pioneering a new era of value-driven care with its Lab Insights Program that captures, digitizes, and analyzes lab results in real-time to provide actionable insights for earlier disease detection, ensuring appropriate treatment protocols and driving down overall costs.

Avalon is a portfolio company of Francisco Partners, a global private equity firm that specializes in investments in technology and technology-enabled service companies. Avalon is a high growth company where every associate has an opportunity to make a difference.

Avalon has years of expertise in managing lab benefits and now is leveraging digitized lab results to drive quality clinical outcomes and proven savings. When you look at how we bring this to life, we offer Lab Insights solutions that work together to arm you with critical lab-driven insights to accelerate your value-driven care success. This is the first-of-its-kind suite of solutions to help you achieve the Triple Aim of improving the patient experience of care, improving the health of populations, and reducing the per-member cost of healthcare.

You will be part of a team that shapes a new market and business. Most importantly, you will help Avalon to achieve its mission and improve clinical outcomes and health care affordability for the people we serve.

For more information about Avalon, please visit www.avalonhcs.com.

About the Customer Success Operations Analyst Position:

The Customer Success Operations Analyst (CSOA) is a key member of the Operations Department, supporting both internal operations and client-facing functions. This position is responsible for driving resolution to client inquiries and issues, including triaging requests, conducting detailed claims research, and communicating findings related to claims coding and editing investigation, as well as claims decisioning. The CSOA works cross-functionally with other departments to conduct impact analyses and deliver reports to health plan clients via ticketing systems or other communication channels. Ideal candidates bring a proactive, solution-oriented approach and can balance tactical execution with strategic thinking— ensuring excellence in both operational efficiency and customer service delivery.

This position is eligible for remote work, but quarterly travel will be required to Avalon's corporate office located in Tampa, Florida.

Customer Success Operations Analyst - Essential Functions and Responsibilities:

• Act as the Operational Subject Matter Expert for client engagement.
• Acquire an in-depth understanding of internal processes to effectively and efficiently resolve customer inquiries.
• Lead meetings with clients (and occasionally providers) on a regular cadence to resolve issues or provide education.
• Respond to client requests and make regular status updates within established turnaround times.
• Develop, run, and execute client queries for internal reports.
• Deliver monthly, quarterly, and ad hoc reports to assigned clients.
• Develop and provide customer (and occasional provider) education as needed.
• Evaluate disputed claims in denial management process for system configuration, claims processing, and/or contractual issues to facilitate health plan review of claims.
• Track client and provider issues and monitor trends to support their resolution, including escalation as required.
• Effectively and accurately communicate client needs and advocate on their behalf.
• Collaborate with the Account Management team and other internal departments to provide excellent customer service to clients.
• Understand departmental needs and recommend process improvements.
• Assist with special assignments and projects that require extensive and thorough research.

Customer Success Operations Analyst – Minimum Qualifications:

• 3+ years’ in a relevant healthcare field – claims processing, claims coding, customer service, and/or account management
• Bachelor’s degree preferred; 5+ years relevant experience in lieu of a degree
• Previous experience working in a health plan or healthcare services company is required.
• Maintains a positive, solutions-oriented mindset, even when faced with ambiguity or shifting priorities.
• Demonstrates a strong sense of ownership and accountability for outcomes and continuous improvement.
• Follows up consistently and respectfully to keep deliverables on track.
• Demonstrates the ability to build strong relationships, both with internal and external stakeholders.
• Able and willing to meet with clients and internal coworkers on video.
• Ability to learn basic SQL queries to run client reports.
• Good working knowledge of Microsoft Office Suite is essential.

Customer Success Operations Analyst – Preferred Qualifications:

• Experience or certification in medical billing and/or coding a plus.

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