Technical Analyst – Claims Automation

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Gravie

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 2013

🏥 Healthcare

🛡️ Insurance

🤝 B2B

💰 $150M Private Equity Round - Gravie on 2025-05

Healthcare • Insurance • B2B

Gravie is a benefits and health insurance solutions company that helps small and midsize employers, brokers, and employees access and administer more flexible, affordable health benefits. Its flagship offerings include Comfort (a level-funded health plan), Gravie ICHRA (Individual Coverage Health Reimbursement Arrangement administration), Gravie Pay (support for healthcare costs), and Gravie Care; the company focuses on enabling SMBs to offer individualized, lower-cost coverage and simplifying benefits administration.

📋 Description

• 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

🎯 Requirements

• 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

🏖️ Benefits

• 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