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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 community

Responsibilities

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

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 community

Responsibilities

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

No positions are currently available. Check back soon!

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 community

Responsibilities

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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