Claims Automation

7 days ago


Schenectady, New York, United States MVP Health Care Full time
About the Role

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.

Key Responsibilities
  • Develop solutions leveraging claims automation and system enhancements to enable faster, more accurate execution of repetitive tasks in production environments.
  • 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.
  • 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.
Requirements
  • Bachelor's Degree or 4 years professional healthcare experience preferred.
  • 2+ years medical claims processing or system configuration experience required.
  • FACETS experience required.
  • Data Analysis experience preferred.
Preferred 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.
About MVP Health Care

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.

Benefits
  • Considerable paid time away from work including PTO, sick time, service time off, paid holidays, and floating holidays.
  • Competitive 401(k) employer matching and profit-sharing program.
  • Low premium health benefits including medical, dental, and vision coverage.
  • Life insurance and disability coverage.
  • Array of optional benefit plans such as accident insurance and specified disease coverage.
  • Full tuition reimbursement for approved courses and programs.
  • Best-in-class employee Well-Being program.


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