Medicare Claims Processing, Professional, CASE Analyst

2 weeks ago

Schenectady, United States MVP Health Care Full time
Medicare Claims Processing, Professional, CASE Analyst

Headquarters Office, 625 State Street, Schenectady, New York, United States of America • Rochester Office, 20 S. Clinton Ave, Rochester, New York, United States of America Req #2130

Wednesday, August 21, 2024

Over 35 years strong and fueled by 1,700 smart, passionate employees across New York state and Vermont, MVP is full of opportunities to grow. We are a nationally recognized, award-winning leader for a reason. The beating heart of our company is a wide range of employees from a diverse set of backgrounds-tech people, numbers people, even people people-working together to make health insurance better. If you are ready to join a thriving, mission-driven company where you can create your own opportunities and make a positive difference-it's time to make a healthy career move to MVP

Full-Time, Exempt

The Professional, Claim Automation & System Enhancement Analyst will join the Operations Claims team to develop solutions leveraging claims automation and system enhancements to enable faster, more accurate execution of repetitive tasks in production environments. They will work collaboratively with the RPA team and other business units across the organization developing requirements, analyzing data, performing process review, creating workflows. and developing recommendations for improvement. Maintain detailed documentation as it relates to projects and departmental initiatives following program standards. Will be able to analyze data to perform root cause analysis focusing on increasing accuracy and/or delivering ROI. Work in an Agile environment to elicit, record and develop Business Requirements; work with the RPA team to convert Business Requirements to System Requirements. Presents and provides status on program initiatives. Executes tasks timely and escalates roadblocks to success to OPS Leadership for resolution. Perform other job duties as assigned.

POSITION QUALIFICATIONS

Minimum Education:
  • Bachelor's Degree or 4 years professional healthcare experience preferred.
Minimum Experience:
  • 2+ years medical claims processing or system configuration experience required
  • FACETS experience required
  • Data Analysis experience preferred

Required Skills:
  • Customer focus and demonstrated experience working with business users to solve issues and develop requirements to support process improvements.
  • Ability to lead change through people, process, and technology.
  • Comfortable working in a team environment as well as independently and possess a sense of accuracy and urgency in completing assignments.
  • Excellent organizational and communication skills.
  • Ability to manage multiple assignments with a high level of autonomy and independence.
  • Microsoft Office Suite: Excel, Outlook Word

Preferred Skills:
  • Ability to prioritize multiple assignments with attention to details and deadlines in a high volume environment
  • Microsoft Office Suite: Visio, Teams, Planner, Power point

About MVP

MVP Health Care is a nationally recognized, not-for-profit health insurer caring for members in New York and Vermont. Committed to the complete well-being of our members and the communities we serve, MVP makes health insurance more convenient, more supportive, and more personal. We are powered by the ideas and energy of more than 1,700 diverse employees from all backgrounds, committed to having a positive impact on the health and wellness of everyone we serve.

At MVP, we are committed to providing competitive employee compensation and benefits packages. The base pay range provided for this role reflects our good faith compensation estimate at the time of posting. Specific employment offers and associated compensation will be made individually based on several factors , including but not limited to geographic location ; relevant experience, education, and training; and the nature of and demand for the role.

In addition, we offer a comprehensive benefits package that includes:

  • Considerable paid time away from work including PTO (Paid Time Off), s ick t ime, service t ime o ff, p aid h olidays, and f loating h olidays , allowing you to take time off when it suits you best.
  • Competitive 401(k) employer matching and profit-sharing program to help you save for your retirement.
  • Low premium health benefits including medical, dental, and vision coverage to support your well-being and that of your family.
  • Life insurance and disability coverage to ensure financial security for you and your dependents.
  • An array of optional benefit plans such as accident insurance and specified disease coverage to protect you from the unexpected.
  • Full tuition reimbursement (up to the IRS limit) for approved courses and programs that support continuous learning.
  • A best-in-class employee Well-Being program to support all dimensions of your health and wellness.
MVP Health Care analyzes the latest market data to determine employee compensation. Compensation figures listed in a job posting are subject to change as new market data becomes available. The salary range, other compensation, and benefits information is accurate as of the date of this posting. MVP Health Care reserves the right to modify this information at any time, subject to applicable law. More detailed information about total compensation and benefits will be provided during the hiring process.

MVP Health Care is an Affirmative Action/ Equal Employment Opportunity (PDF). We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, genetic information, veteran status, or any other basis, e.g., Pay Transparency (PDF), and the Know your Rights protected by applicable federal, state or local law. Any person with a disability needing special accommodations to the application process, please contact Human Resources at hr@mvphealthcare.com

Please apply and learn more - including how you may become a proud member of our team.

Other details
  • Job Family Claims/Operations
  • Pay Type Salary
  • Min Hiring Rate $52,423.00
  • Max Hiring Rate $70,925.00

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