US Claro logo
US Claro

⭕️ Managed IT Services provider delivering scalable solutions with layers of security and global expertise.

Systems Analyst II, Claim Adjudication

Systems EngineerSystems EngineerFull TimeRemoteSeniorTeam 201-500Since 1990Company SiteLinkedIn

Location

Idaho

Posted

56 days ago

Salary

$67.7K - $81.5K / year

Seniority

Senior

Associate Degree3 yrs expExperience acceptedEnglish

Job Description

Systems Analyst II, Claim Adjudication

US Claro

• Maintain detailed knowledge of the claim adjudication system capabilities and limitations • Provide subject matter expertise, participate in the design of innovative solutions to improve system configuration, claim processing, and the accuracy and efficiency of claims processing • Support large effort initiatives within the claims adjudication space • Identify risk, deliver quantified fact-based supporting details and provide a recommendation and detailed plan for mitigation • Mentoring of less experienced team members • Ensure accurate security configuration within the claims adjudication platform to minimize unauthorized access • Review and understand NCPDP workgroup outcomes, participate in appropriate NCPDP task groups, share industry best practices and standards • Other duties as assigned

Job Requirements

  • A two-year college or university degree and/or a minimum of three years of work experience is required
  • Professional PBM industry work experience is required
  • Knowledge of applicable data privacy practices and laws is preferred
  • Healthcare industry practices and HIPAA knowledge
  • Experience as a member of a multi-disciplinary team
  • Understanding of Agile methodology a plus
  • Participate in, adhere to, and support compliance program objectives
  • The ability to consistently interact cooperatively and respectfully with other employees

Benefits

  • Top of the industry benefits for Health, Dental, and Vision insurance
  • 20 days paid time off
  • 4 weeks paid parental leave
  • 9 paid holidays
  • 401K company match of up to 5% - No vesting requirement
  • Adoption Assistance Program
  • Flexible Spending Account
  • Educational Assistance Plan and Professional Membership assistance
  • Referral Bonus Program – up to $750!

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