Brighton Health Plan Solutions ยท 1 day ago
Programmer Analyst
United States
Full-time
Remote
Mid Level
3+ years exp
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Hiring Manager
Paul Pascale
Insider Connection @Brighton Health Plan Solutions
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Responsibilities
Collect and analyze requirements to develop effective solution designs.
Effectively handle the data transformation activities
Program new provider physician rate builds and manage ongoing rate changes
Implement new groups eligibility files and manage ongoing eligibility files
Program new benefit configuration and manage ongoing benefit changes
Troubleshoot errors during the load process and claims adjudication process communicating the outcome to appropriate stakeholders
Interact with system vendors to enhance applications with new features and functionality
Communicate with IT management on the progress of the various initiatives
Collaborate with IT and non-IT personnel to complete required tasks
Qualification
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Required
At least 3 years prior experience in Healthcare TPA or insurer environment working with the claims adjudication and ancillary applications
Familiarity with Healthcare EDI transactions including 800 and 200 series
Ability to understand complex HealthCare payment rules and design, build and implement system accordingly
Must possess the ability to manage multiple tasks with minimal supervision
Communicate effectively with internal and external stakeholders
Strong attention to detail and perform consistent work product validation/QA
Strong analytical skills
Conversant with data integrity principles
3+ years of experience with SQL queries that includes but not limited to- ability to extract the data, triaging, update and insert functions
Undergraduate degree in IT, Healthcare IT and/or progressive experience
Familiar with MS Office suite products
Proficient on Excel and MS Access
Proficient on MS SQL Server Managed Studio
Company
Brighton Health Plan Solutions
Brighton Health Plan Solutions is a health care company that specializes in health plan management service.
201-500 employees
Funding
Current Stage
Growth StageLeadership Team
Jim Cusumano
Co-Founder, President and CEO
Recent News
Company data provided by crunchbase
