Network Integration Technical Analyst

🔥 9 minutes ago

🇺🇸 United States – Remote

💵 $25 - $47 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

📞 Support Engineer

👻 Ghost score 0%

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Luminare Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

💼 Consulting

📦 Logistics

Healthcare • Consulting • Logistics

Luminare Health is a leading provider of self-funded health plan administration services with over 50 years of industry experience. The company specializes in offering flexible and innovative solutions for hospitals, health systems, and direct-to-employer initiatives, focusing on administration, cost management, and digital reporting tools. Luminare Health is dedicated to being a reliable partner in managing healthcare costs and supporting strategic growth for its clients. The company emphasizes a member-centered approach to healthcare while delivering significant savings through expert claim analysis and management of high-cost claims.

📋 Description

• Build and monitor multiple functions within the Integrated Client Environment (ICE) • Support the Provider Network Integration team and the Luminare Health organization • Identify issues proactively to minimize negative impact on the Luminare Health business • Work with team members, Luminare Health departments, networks and clients to resolve problems • Query and analyze data using SQL • Interpret external vendor network documentation and support claim routing and pricing processes

🎯 Requirements

• High School diploma or equivalent required • A minimum of four years of experience working in medical claims, provider maintenance or network support environments • Strong organizational, collaborative and interpersonal skills • Strong troubleshooting and analytical skills • Ability to read, understand and interpret external vendor network documentation • Understanding of claim routing and claim pricing processes • Ability to work in a fast-paced, customer-service-focused organization • Ability to work effectively with team members, other Luminare Health departments, networks and clients • Ability to effectively deal with problems and see through to resolution • Excellent verbal and written communication skills • Experience using SQL to query and analyze data • Strong understanding of Excel • Bachelor's Degree preferred • Knowledge of PowerSTEPP, HealthEdge, Facets, or similar claim payment/pricing engines preferred • Experience working in a TPA and/or payer operation preferred • Understanding of EDI terminology and file structures (837/835/etc.) preferred • Strong ability to perform root-cause analysis preferred • Familiarity with .NET or other programming/scripting languages, including experience working with conditional business rules, decision logic, or automated claim processing workflows preferred

🏖️ Benefits

• Health and wellness benefits • 401(k) savings plan • Pension plan • Paid time off • Paid parental leave • Disability insurance • Supplemental life insurance • Employee assistance program • Paid holidays • Tuition reimbursement • Other incentives • Annual incentive bonus plan subject to the terms and conditions of the plan