Curative · 2 days ago
System Business Analyst
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Health CareHealth Diagnostics
H1B Sponsor Likely
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Responsibilities
Work closely with Senior Management to collaborate on strategy to meet company goals.
Collaborate closely with the Client Services, Product, and Engineering teams in planning and execution of strategic objectives.
Lead a high-performing team of analysts responsible for the development and support of product configurations that drive our world-class software products.
Successfully Lead the System Configuration team day-to-day operations of the Curative
Consistently ensure the tasks for System Configuration teams are performed and completed & communicated to the other team members
Coordinate the planning, prioritization, and timeline of work tied to meeting company and team goals while closely tracking and communicating around the complex network of dependencies (and potential blockers)
Become a subject matter expert and leader in our business, Health Edge product
Lead by example, taking a senior role in the day-to-day work of the team.
Provide guidance and leadership in the implementation and maintenance of processes and systems to mature the operations of the team
Develop a humble, fun-loving, and highly communicative and collaborative team culture.
Develop key milestones for the team and lead the execution of team initiatives.
As part of a growing company, all employees wear multiple hats and contribute to the success of our company in multiple ways.
Contribute to the growth of the company by helping the team succeed and meet team goals.
Foster a pleasant working environment that inspires the team.
Self-motivation to have an outsized impact with minimal oversight.
Ability to see the big picture and make connections based on daily operations.
Work closely with IT, Medical Services, System Support, to ensure efficiency
Provider Contracts Configuration and design changes in Health Edge.
Daily Work with the Claims Processing team to ensure day-to-day claims processing are being handled in a timely manner.
Works on claims team projects and reporting, assigned.
Attending departmental training when required or requested.
Adheres to the rules and regulations of Curative as described in the Employee Handbook and as defined in the unit/department/clinic procedures.
SaaS software experience.
Health Insurance industry experience.
Qualification
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Required
At least 10-12 years of Health Care EDI 837’s, Claims Processing E2E and Health Plan Configuration along with Knowledge of Optum Products such as CES/PPS Health Edge experience required, including HMO, PPO, ERISA, and Medicare Advantage, Medicaid plans experience.
Knowledge of CMS Fee schedules
Required Experience working with Health Edge- Health Rules Payer system, a variety of claims payment systems, processing of all claim types, to include hospital/facility, behavioral health, dental, vision, and professional medical claims.
Experience working with the VBA claims system.
Ability to communicate with all levels of staff.
Advanced Knowledge of claim coding and editing rules Optum/CMS
Knowledge of TDI regulations and requirements for claims payments
Knowledge of HIPPA regulations
Knowledge of medical terminology, ICD-10 CPT, and HCPCS coding.
Proficient computer skills to include Microsoft Office applications and Google Sheet
Excellent verbal and written communication skills
Ability to communicate clearly and effectively.
Ability to sit for extended periods of time at a computer workstation.
Ability to Multitask and think creatively.
Enrollment/ Eligibility 834’s EDI 837’s
Health Edge HRP and Optum Interfaces expertise
SQL knowledge is required
Company
Curative
Employer-sponsored health insurance with No Copays, No Deductible. No... Really.
H1B Sponsorship
Curative has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2022 (2)
2021 (4)
Funding
Current Stage
Growth StageTotal Funding
$8MKey Investors
Justin Mateen
2020-09-23Seed· $8M
2020-02-01Seed· Undisclosed
Recent News
Coverager - Insurance news and insights
2024-02-06
2023-11-28
2023-03-13
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