Claims Operations Systems Analyst - Remote

Overview

The Claims Operations Systems Analyst will serve as a subject matter expert for claims processing systems and lead technology development projects to ensure accurate claims processing.

In Short

• Provide expertise on claims systems and processes.
• Create and maintain Standard Operating Procedures (SOPs).
• Support technology and process improvement projects.
• Monitor vendor platform functionality and KPIs.
• Coordinate testing processes for claims platforms.
• Build strong relationships with vendors.
• Facilitate internal user feedback on platforms.
• Demonstrate core values of authenticity and results-driven orientation.
• 5 years of experience in business analysis or product management.
• Expertise in claim adjudication processes.

Requirements

• Bachelor’s Degree or equivalent experience.
• 5 years of experience in the healthcare industry.
• Exceptional analytical and problem-solving skills.
• Advanced technical skills, familiarity with Javelina preferred.
• Strong communication and documentation skills.
• Experience in project management.
• Certifications in Business Analysis or Product Management are a plus.
• Understanding of stop-loss and reinsurance operations is a plus.
• Six Sigma Green Belt certification is a plus.

Benefits

• Flexible PTO and paid parental leave.
• Comprehensive health and wellness benefits.
• 401k program with company contributions.
• Cell phone reimbursement and transportation perks.
• Education reimbursement opportunities.
• Unique benefits program including alternative medicine coverage.
• Supportive work culture focused on positive impact.
• Opportunities for career growth and development.
• Above average total rewards package.