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Insurance Claims System Administrator
hace 2 semanas
Job Overview: As a Claims Integration Specialist at The Global Talent Co., you will play a critical role in shaping the future of our company's mission to deliver personalized health solutions.
About the Role: This is an exciting opportunity to work on the front lines of our company's mission, handling initial setup and ongoing maintenance of claims data feeds. You will collaborate closely with cross-functional teams, including Implementation, Account Management, Client Delivery, and Operations.
Main Responsibilities:
- Maintain a strong working knowledge of Personify Health products
- Work with Implementation, Account Management and Client Delivery to implement new claims file integrations into the Personify Health platform
- Participate in data interchange meetings with claims data providers, including file requirement reviews, mapping overviews, data analysis of issues and/or file testing
- Create and maintain requirement documentation, including business rules, file mapping and transformation process specifications for all inbound claims files
- Collaborate with Integrations and DSR teams to ensure claims integrations align to configuration and reporting needs
- Build claims file mappings to match agreed upon requirements
- Process and analyze claims files delivered to Personify Health
- Engage in detailed analysis of data discrepancies to determine the source and resolution of errors
- Respond to and resolve routine requests and questions
- Develop, implement, and enhance processes to drive overall performance of claims integration
Requirements:
- Bachelor's degree in Business/Statistics/Information Science or equivalent in a related discipline
- Good understanding of the healthcare payer space with a minimum of 3 years of claims experience preferred
- 3-5 years of professional work experience in data management, information systems, data analytics
- Willingness to learn new tools that manipulate, analyze, and visualize data
- Strong knowledge of MS Office suite, especially Excel, PowerPoint, and MS Project
- SQL preferred
- Strong technical aptitude
- Excellent interpersonal and writing skills
- Strong organizational skills and detail orientation
- Ability to work cross-functionally with co-workers and with external channel partners
- Able to work independently as well as part of a team
- Solid analytical and problem-solving skills
- High level of professionalism and positive work behavior
About Us: At The Global Talent Co., we are passionate about delivering personalized health solutions that make a meaningful difference in people's lives. If you share our passion and commitment to excellence, we encourage you to apply for this exciting opportunity.
