Claims Integration Specialist

hace 3 semanas

Buenos Aires, Buenos Aires C.F., Argentina The Global Talent Co. A tiempo completo

Overview: Now is the time to join us We're Personify Health. We're the first and only personalized health platform company to bring health, wellbeing, and navigation solutions together. Helping businesses optimize investments in their members while empowering people to meaningfully engage with their health. At Personify Health, we believe in offering total rewards, flexible opportunities, and a diverse inclusive community, where every voice matters. Together, we're shaping a healthier, more engaged future.

Responsibilities

Who are you? The role of Claims Integration Specialist is primarily responsible for handling initial setup and ongoing maintenance of claims data feeds. This role will collaborate closely with the Implementation team, Account Management, Client Delivery, and other Operation teams to support the claims lifecycle. This position may require some occasional travel, less than 5%.

In this role you will wear many hats, but your knowledge will be essential in the following:

  1. Maintain a strong working knowledge of Personify Health products.
  2. Work with Implementation, Account Management and Client Delivery to implement new claims file integrations into the Personify Health platform.
  3. Participate in data interchange meetings with claims data providers that may include file requirement reviews, mapping overviews, data analysis of issues and/or file testing.
  4. Create and maintain requirement documentation that include business rules, file mapping and transformation process specifications for all inbound claims files.
  5. Collaborate with Integrations and DSR teams to ensure claims integrations align to configuration and reporting needs.
  6. Build claims file mappings to match agreed upon requirements.
  7. Process and analyze claims files delivered to Personify Health.
  8. Engage in detailed analysis of data discrepancies to determine the source and resolution of errors.
  9. Respond to and resolve routine requests and questions.
  10. Develop, implement, and enhance processes to drive overall performance of claims integration.
  11. Perform additional duties as requested.

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Qualifications

What you bring to the Personify Health Team:

  1. Bachelor's degree in Business/Statistics/Information Science, or equivalent, in related discipline.
  2. Have a good understanding of the healthcare payer space with a minimum of 3 years of claims experience preferred.
  3. 3-5 years of professional work experience in data management, information systems, data analytics.
  4. Willingness to learn new tools that manipulate, analyze, and visualize data.
  5. Strong knowledge of MS Office suite, especially Excel, PowerPoint, and MS Project.
  6. SQL preferred.
  7. Strong technical aptitude.
  8. Excellent interpersonal and writing skills.
  9. Strong organizational skills and detail orientation.
  10. Required to work cross-functionally with co-workers and with external channel partners.
  11. Ability to work independently as well as part of a team.
  12. Solid analytical and problem-solving skills.
  13. A high level of professionalism and positive work behavior.

Personify Health is an equal opportunity organization and is committed to diversity, inclusion, equity, and social justice. We strive to cultivate a work environment where differences are celebrated, and employees of all backgrounds are empowered to thrive. Personify Health is committed to driving Diversity, Equity, Inclusion and Belonging (DEIB) for all stakeholders: employees (at each organization level), members, clients and the communities in which we operate. Diversity is core to who we are and critical to our work in health and wellbeing.

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