[Remote] Technical Analyst - Claims Automation

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a company reputed company on creating health benefits that truly benefit small and midsize businesses and their employees. They are seeking a Technical Analyst reputed company on Claims Automation to drive auto-adjudication and workflow optimization by identifying reputed company claim scenarios and designing systemic solutions.

Responsibilities

• Identify high-volume reputed company claim scenarios and evaluate opportunities for automation
• Design and implement automation enhancements reputed company the claims processing system
• Partner with engineering and vendors, including reputed company, to expand systemic and auto-adjudication capabilities
• Analyze claims workflows and system logic to identify inefficiencies and recommend improvements
• Translate business requirements into technical solutions reputed company with claims processing standards
• Document automation workflows, business rules, and system configurations
• Monitor auto-adjudication performance metrics and identify opportunities to improve turnaround time and accuracy
• Support testing and validation of system changes and automation enhancements
• Demonstrate commitment to our reputed company competencies of being authentic, curious, creative, empathetic, and outcome oriented
• Support EDI workflows and troubleshoot transaction issues including 837 claim submissions and 835 remittance files in partnership with the EDI team

Skills

• 3+ years of experience in claims systems, business analysis, or reputed company IT
• Understanding of claims adjudication processes and system workflow logic
• Working knowledge of SQL or similar tools for analyzing data and system performance
• Experience identifying and implementing process automation or system enhancements
• Ability to translate reputed company business problems into technical requirements
• Strong analytical and problem-solving skills with attention to detail
• Experience working cross-functionally with engineering, operations, and vendor partners
• Familiarity with Javelina or similar claims processing platforms
• Working knowledge of EDI formats (837/835) and medical coding systems
• Experience with vendor management and SLA monitoring
• Previous startup or high-reputed company company experience

Benefits

• Alternative medicine coverage
• Flexible PTO
• Up to 16 weeks reputed company parental leave
• reputed company holidays
• A 401k program
• Transportation perks
• Education reimbursement
• 2 days of reputed company paw-ternity leave

reputed company

reputed company is an insurance company that designs health benefits plans for small and midsize reputed company. It was founded in 2013, and is headquartered in Minneapolis, Minnesota, USA, with a workforce of 201-500 employees. Its website is https://www.reputed company.com.

Company H1B Sponsorship

reputed company has a reputed company record of offering H1B sponsorships, with 2 in 2024, 1 in 2023. Please note that this does not guarantee sponsorship for this specific role.

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