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Case management
No positions are currently available. Check back soon!
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Claims
Claims Research Analyst
Austin, TX (Partially Remote), Full Time, Day, Job ID: 294884
Details
- Department:Patient Accounting
- Schedule:Full-Time, 8-hour day shift, Monday - Friday, Partially Remote
- Facility: Ascension Care Management Insurance
- Location:Austin, Texas
Benefits
Paid time off (PTO)
Various health insurance options & wellness plans
Retirement benefits including employer match plans
Long-term & short-term disability
Employee assistance programs (EAP)
Parental leave & adoption assistance
Tuition reimbursement
Ways to give back to your communityResponsibilities
As a Claims Research Analyst, you'll analyze claims information for risk management and insurance programs.
- Investigate claims and obtain relevant facts to determine coverage, loss and liability.
- Oversee legal and medical aspects of claim including oversight of law firms involved in the litigation of the claim.
- Resolve claim issues promptly and manage claim settlements within authority limits.
- Provide recommendation of claim and expense reserves.
- Strong knowledge of Texas Medicaid pricing.
Requirements
Education:
- High School diploma equivalency with 2 years of cumulative experience OR Associate's degree/Bachelor's degree OR 4 years of applicable cumulative job specific experience required.
Additional Preferences
Additional preferences:
- 1 to 2 years of appeals experience, preferred.
- 1 to 2 years of Texas health plan operations experience, preferred.
- 1 to 2 years of strong claims auditing and investigation experience, preferred.
- 1 to 2 years of strong claims research experience, involving collecting relevant inforamation to design meaningful data to create a set conclusion to have claims reprocessed, preferred.
Apply at: https://jobs.ascension.org/us/en/job/1087419/Claims-Research-Analyst
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Configuration
Facets Networx Configuration Lead
Troy, MI (Partially Remote), Full Time, Day, Job ID: 282900
Details
- Department: Acension Care Solutions Development
- Schedule:Full-Time, 8-hour day shift, Monday - Friday - Partially Remote
- Facility: Automated Benefit Services (ABS)
- Location: Troy, Michigan
Benefits
Paid time off (PTO)
Various health insurance options & wellness plans
Retirement benefits including employer match plans
Long-term & short-term disability
Employee assistance programs (EAP)
Parental leave & adoption assistance
Tuition reimbursement
Ways to give back to your communityResponsibilities
As a Facets Networx Configuration Lead, you'll work with assigned customers/areas to translate business requirements into application/system solutions.
- Serve customers as a key point of contact.
- Manage customer expectations and ensure prompt and complete customer service.
- Form productive networks with internal and external customers and the vendor community.
- Produce project plans, RFP's, and RFI's.
- Customize presentations to the interests of the audience.
- Conduct diagnosis of most business problems.
- Design, direct and perform analyses to resolve complex first-time project issues including analysis of technical and economic feasibility of proposed system solutions.
- Design projects with broad implications requiring systems integration of one or more technical platforms.
- Lead design sessions by presenting logical statements of business problems and designs.
- Participate in the design of technical requirements for the application/solution.
- Serve as a staff resource and mentor regarding understanding of architectural systems.
Requirements
Education:
- High School diploma equivalency with 2 years of cumulative experience OR Associate's degree/Bachelor's degree OR 4 years of applicable cumulative job specific experience required.
Additional Preferences
Additional Preferences:
- 2 years of Facets Networx intergration experience, preferred.
- 2 years of Facets application in Networx experience, preferred.
- 2 years of Health Plan experience, preferred.
- 2 years of SQL and Query Data experience, preferred.
- 2 years of Claims Test Pro experience, preferred.
Apply at: https://jobs.ascension.org/us/en/job/1066368/Facets-Networx-Configuration-Lead
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Customer serviceNo positions are currently available. Check back soon!
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Enrollment
No positions are currently available. Check back soon!
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Information systems
Business Analyst Government Programs
Remote, Full Time, Day, Job ID: 290567
Details
- Department:Acension Care Operations
- Schedule:Full-Time, 8-hour day shift, Monday - Friday, Fully Remote
- Facility: Automated Benefit Services (ABS)
Benefits
Paid time off (PTO)
Various health insurance options & wellness plans
Retirement benefits including employer match plans
Long-term & short-term disability
Employee assistance programs (EAP)
Parental leave & adoption assistance
Tuition reimbursement
Ways to give back to your communityResponsibilities
As a Business Analyst Government Program, you will evaluate, implement and maintain assigned business systems and applications.
- Develop program goals and infrastructure to align with defined business strategy.
- Manage program through creating program plans, management tools and reporting capabilities.
- Lead cross-functional teams and ensure resources are assigned to meet program goals.
- Recommend program budget and monitor and adjust plan as resource requirements change.
- Communicate and document program quality outcomes and progress metrics.
- Address and resolve project issues to ensure goals remain on track.
- Assist in evaluating proposals for data collection through an understanding of the functional area's business and applications needs.
- Assist in planning and implementing activities required for the collection and analysis of data related to departmental business needs, including the development of data collection systems.
- Maintain specific departmental data collection systems (eg , databases and spreadsheets) by troubleshooting problems, providing user support and education and promoting integration with other systems.
- Develop and run basic queries and other data collection spreadsheets to support assigned business areas and organize them in a format for ease of review and use.
- Distill business processes to key functions and create and document processes to identify opportunities to automate and/or improve an existing process.
- Assist in conducting complicated and detailed analyses of data relative to the applicable business function.
- Knowledge of Facets
- Knowledge of Claims Systems.
- Knowledge of Healthplan and ACA Marketplace Insurance.
Requirements
Education:
- High School diploma equivalency with 2 years of cumulative experience OR Associate's degree/Bachelor's degree OR 4 years of applicable cumulative job specific experience required.
Additional Preferences
- 1-2 years of working knowledge of government related Medicaid, ACA insurance plans rules, regulations and requirement levels experience, preferred.
- FACETS experience, plus.
Apply here: https://jobs.ascension.org/us/en/job/1081505/Business-Analyst-Government-Programs
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Project management
No positions are currently available. Check back soon!