Technical Analyst – Claims Automation

🕒 Julho 28

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Gravie

SiteLinkedInTodas as Vagas

201 - 500 funcionários

Fundada em 2013

🏥 Saúde

🛡️ Seguros

🤝 B2B

💰 $150.000.000 Private Equity Round - Gravie em 2025-05

Healthcare • Insurance • B2B

A Gravie é uma empresa de soluções de benefícios e seguros de saúde que ajuda pequenas e médias empresas, corretores e funcionários a acessar e administrar benefícios de saúde mais flexíveis e acessíveis. Seus principais produtos incluem Comfort (um plano de saúde com financiamento em nível definido), Gravie ICHRA (administração de Arranjo de Reembolso de Saúde para Cobertura Individual), Gravie Pay (suporte para custos de saúde) e Gravie Care. A empresa se concentra em capacitar PMEs a oferecer cobertura individualizada e de menor custo, além de simplificar a administração de benefícios.

Descrição

• Identify high-volume manual claim scenarios and evaluate opportunities for automation • Design and implement automation enhancements within the claims processing system • Partner with engineering and vendors, including Mphasis, to expand systemic and auto-adjudication capabilities • Analyze claims workflows and system logic to identify inefficiencies and recommend improvements • Translate business requirements into technical solutions aligned with claims processing standards • Document automation workflows, business rules, and system configurations • Monitor auto-adjudication performance metrics and identify opportunities to improve turnaround time and accuracy • Support testing and validation of system changes and automation enhancements • Demonstrate commitment to our core competencies of being authentic, curious, creative, empathetic, and outcome oriented • Support EDI workflows and troubleshoot transaction issues including 837 claim submissions and 835 remittance files in partnership with the EDI team

🎯 Requisitos

• 3+ years of experience in claims systems, business analysis, or healthcare IT • Understanding of claims adjudication processes and system workflow logic • Working knowledge of SQL or similar tools for analyzing data and system performance • Experience identifying and implementing process automation or system enhancements • Ability to translate complex business problems into technical requirements • Strong analytical and problem-solving skills with attention to detail • Experience working cross-functionally with engineering, operations, and vendor partners

🏖️ Benefícios

• Alternative medicine coverage • Flexible PTO • Up to 16 weeks paid parental leave • Paid holidays • 401k program • Transportation perks • Education reimbursement • 2 days of paid paw-ternity leave