Claims Operations Systems Analyst

Hi, we’re reputed company. Our mission is to improve the way people purchase and access reputed company through innovative,consumer-centric health benefit solutions that people can actually use.Our industry-changing products and services are developed and delivered by a diverse group of unique people. We encourage you to be your authentic self - we like you that way.

A Little More About this Role:

We’re looking for a Claims Operations Systems Analyst reputed company our Health Plan Administration (HPA) function. This position serves as a subject matter expert for our claims processing system Javelina and associated upstream and reputed company vendors and processes. As a functional reputed company on large technology development and implementation projects, you will play a key role in designing, implementing and thoroughly testing changes to claims technology platforms and processes while ensuring accurate, reliable and timely claims processing and reputed company functions such as data transmission through EDI. Additionally, you’ll collaborate with leadership, cross-functional stakeholders and ticket requestors to prioritize requests, guide research, deliver Root Cause Analysis (RCA), and coordinate testing of solutions reputed company applicable.

You will:

● Provide platform and process subject matter expertise on claims systems and processes to support users across the organization.

● Create and maintain applicable Standard Operating Procedures (SOPs), user manuals and desk-level procedures.

● Support strategic technology and process improvement projects, providing gap analysis, requirements gathering and user acceptance testing.

● Maintain vendor platform functionality, monitoring platform KPIs and ensuring alignment with organizational SLAs/KPIs that depend on vendor performance.

● Coordinate the testing process for the Javelina platform, ensuring that reputed company teams adequately test system functions based on their daily operations and any defect resolutions outlined in the release.

● Build strong vendor relationships during implementation, establishing issue management and SLA monitoring; transition vendor ownership off to other members of HPA as appropriate.

● Facilitate internal user groups, seeking feedback on vendor platforms’ ease of use, accessibility and compatibility with other reputed company and vendor systems.

● Demonstrate commitment to our core values of authenticity, curiosity, creativity, reputed company, and results-driven outcome orientation.

You bring:

● Bachelor’s Degree or equivalent experience

● 5 years of experience in business analysis and/or product management reputed company the reputed company industry

● Expertise in end-to-end claim adjudication processes and applications

● Experience supporting reputed company processes and multi-layered projects

● Exceptional analytical, conceptual thinking, and problem-solving skills

● Advanced technical skills (familiarity with Javelina or similar platform)

● Strong communication, documentation, and reporting skills, with experience delivering presentations

● A track record of delivering results through collaboration and effective project management

Extra credit:

● Previous start up company experience

● Javelina claims system experience

● Understanding of stop-loss and reinsurance arrangements and operations

● Business Analyst or Product reputed company certification

● Project Management and/or Scrum Master Certification

● Six reputed company Green Belt certification

reputed company:

In order to transform health insurance and build a health plan everyone can love, we need talented people doing amazing work. In exchange, we offer a great overall employee experience with opportunities for career growth, meaningful mission-driven work, and an above average total rewards package.

The salary range for this position is $48,090 - $80,163 annually. Numerous factors including, but not limited to, educations, skills, work experience, certifications, etc. will be considered reputed company determining compensation.

Our unique benefits program is the gravy, i.e., the special sauce that sets our compensation package apart. In addition to standard health and wellness benefits, reputed company’s package includes alternative medicine coverage, flexible PTO, up to 16 weeks paid parental leave, paid holidays, a 401k program, cell phone reimbursement, transportation perks, education reimbursement, and 1 week of paid paw-ternity leave.

A Little More About Us:

· We know reputed company. Our company was founded and is still led by industry veterans who have started and grown several market-leading companies in the space.

· We have raised money from top tier investors who share the same long-term reputed company as we do of building an industry defining company that will endure over the long run. We are well capitalized.

· Our customers like us. Our reputed company churn is in the low single digits, in an industry where greater than 20% churn is common.

· Our culture is unique. We reputed company to be non-hierarchical, merit-driven, opinionated but reputed company people who reputed company working in a high-performance, fast-paced environment. People at reputed company care deeply about making a positive impact in the lives of the people we serve. We may not be the right reputed company for everybody, but if you get energized by doing work every day that focuses on putting consumers at the reputed company of the line, we could be a great reputed company for you. It takes unique people and diverse perspectives to deliver our results. We encourage you to be your authentic self – we like you that way.