The Claims Operations Systems Analyst will provide subject matter expertise on claims processing systems, collaborate on technology projects, manage vendor relationships, and ensure timely claims processing through testing and documentation efforts.
Hi, we’re Gravie. Our mission is to improve the way people purchase and access healthcare through innovative, consumer-centric health benefit solutions that people can actually use. Our industry-changing products and services are developed and delivered by a diverse group of unique people. We encourage you to be your authentic self - we like you that way.
A Little More About this Role:
We’re looking for a Claims Operations Systems Analyst within our Health Plan Administration (HPA) function. This position serves as a subject matter expert for our claims processing system Javelina and associated upstream and downstream vendors and processes. As a functional lead on large technology development and implementation projects, you will play a key role in designing, implementing and thoroughly testing changes to claims technology platforms and processes while ensuring accurate, reliable and timely claims processing and related functions such as data transmission through EDI. Additionally, you’ll collaborate with leadership, cross-functional stakeholders and ticket requestors to prioritize requests, guide research, deliver Root Cause Analysis (RCA), and coordinate testing of solutions when applicable.
You will:
● Provide platform and process subject matter expertise on claims systems and processes to support users across the organization.
● Create and maintain applicable Standard Operating Procedures (SOPs), user manuals and desk-level procedures.
● Support strategic technology and process improvement projects, providing gap analysis, requirements gathering and user acceptance testing.
● Maintain vendor platform functionality, monitoring platform KPIs and ensuring alignment with organizational SLAs/KPIs that depend on vendor performance.
● Coordinate the testing process for the Javelina platform, ensuring that all teams adequately test system functions based on their daily operations and any defect resolutions outlined in the release.
● Build strong vendor relationships during implementation, establishing issue management and SLA monitoring; transition vendor ownership off to other members of HPA as appropriate.
● Facilitate internal user groups, seeking feedback on vendor platforms’ ease of use, accessibility and compatibility with other Gravie and vendor systems.
● Demonstrate commitment to our core values of authenticity, curiosity, creativity, empathy, and results-driven outcome orientation.
You bring:
● Bachelor’s Degree or equivalent experience
● 5 years of experience in business analysis and/or product management within the healthcare industry
● Expertise in end-to-end claim adjudication processes and applications
● Experience supporting complex processes and multi-layered projects
● Exceptional analytical, conceptual thinking, and problem-solving skills
● Advanced technical skills (familiarity with Javelina or similar platform)
● Strong communication, documentation, and reporting skills, with experience delivering presentations
● A track record of delivering results through collaboration and effective project management
Extra credit:
● Previous start up company experience
● Javelina claims system experience
● Understanding of stop-loss and reinsurance arrangements and operations
● Business Analyst or Product Owner certification
● Project Management and/or Scrum Master Certification
● Six Sigma Green Belt certification
Gravie:
In order to transform health insurance and build a health plan everyone can love, we need talented people doing amazing work. In exchange, we offer a great overall employee experience with opportunities for career growth, meaningful mission-driven work, and an above average total rewards package.
The salary range for this position is $48,090 - $80,163 annually. Numerous factors including, but not limited to, educations, skills, work experience, certifications, etc. will be considered when determining compensation.
Our unique benefits program is the gravy, i.e., the special sauce that sets our compensation package apart. In addition to standard health and wellness benefits, Gravie’s package includes alternative medicine coverage, flexible PTO, up to 16 weeks paid parental leave, paid holidays, a 401k program, cell phone reimbursement, transportation perks, education reimbursement, and 1 week of paid paw-ternity leave.
A Little More About Us:
· We know healthcare. Our company was founded and is still led by industry veterans who have started and grown several market-leading companies in the space.
· We have raised money from top tier investors who share the same long-term vision as we do of building an industry defining company that will endure over the long run. We are well capitalized.
· Our customers like us. Our revenue churn is in the low single digits, in an industry where greater than 20% churn is common.
· Our culture is unique. We tend to be non-hierarchical, merit-driven, opinionated but kind people who thrive working in a high-performance, fast-paced environment. People at Gravie care deeply about making a positive impact in the lives of the people we serve. We may not be the right place for everybody, but if you get energized by doing work every day that focuses on putting consumers at the front of the line, we could be a great place for you. It takes unique people and diverse perspectives to deliver our results. We encourage you to be your authentic self – we like you that way.
Top Skills
Edi
Javelina
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