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Systems Analyst II, Claim Adjudication
Location
Idaho
Posted
56 days ago
Salary
$67.7K - $81.5K / year
Seniority
Senior
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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