Senior Configuration Analyst
Remote / United States
Health Plan Administration /
Full Time /
Remote
Hi, we’re Gravie, and we are building the health plan of the future. For the past few decades, the health insurance industry has evolved to serve the needs of employers, insurance companies, brokers, and (sometimes) doctors and hospitals. The needs of the consumer, however, have largely been left out of the equation. We’re changing that. We are rebuilding the entire health insurance stack, with the consumer as the central focus. Our goal is to create a health plan that people can love.
At Gravie, you’ll get to do things every single day to support making health benefits easy to understand and simple to navigate. You’ll work at a startup that has demonstrated amazing growth and our future is only getting brighter. We're past the risky early stage, but have only put a dent in the incredible innovations to come. And you’ll join a hugely talented and passionate team. After all, you are our competitive advantage. Our industry-changing products and services couldn’t exist without our talented people thinking about how to make healthcare benefits better every single day. It takes unique people on diverse teams to deliver the kinds of results we deliver. We encourage you to be your authentic self - we like you that way.
We’re looking for a Senior Configuration Analyst to join our configuration team. As Gravie looks to continue its Member-centric approach to healthcare, we need a specialist to create and maintain the benefit categories and logic that power our health plans. Gravie offers a great environment for individuals looking to build a career in health plan configuration and claim processing. Qualified applicants should have an understanding of benefit plans, the coding systems used to document medical services, and the way these codes are organized into benefit categories and used in claim processing logic.
You will:
· Be a Subject Matter Expert in benefit categories and the adjudication logic used to process claims.
· Be a leader on the configuration team by supporting training, process development, and peer review / QA.
· Support cross-functional teams during implementations/renewals and develop solutions for plan variations.
· Provide support to team members for escalations and complex configuration requests.
· Provide troubleshooting support for claim adjudication processes.
· Create and update policies and procedures and other documentation of our accumulators and plan configurations.
· Demonstrate commitment to our core competencies of being authentic, curious, creative, empathetic and outcome oriented.
You bring:
· 3+ years configuring accumulators and benefit plans or other related experience in payer business logic.
· 5+ years of experience as a claims examiner, coder, or other related experience working with medical claims data.
· Experience with adjudication processes, analyzing plan designs, and health plan information systems and applications.
· Knowledge/experience with self-funded plan designs.
· Ability to set priorities, manage time, and work independently.
· Demonstrated success getting results through collaboration.
Extra credit:
· Familiarity with the mPhasis Eldorado Javelina claims processing software.
· Working knowledge of EDI formats (837/835 claims, 270/271 eligibility) and coding systems (CPT/HCPCS, ICD, DRG).
· Experience in rapidly-growing start-up business environments.
Competitive pay is standard. Our unique benefits program is the gravy, i.e., the special sauce that sets our compensation package apart. In addition to standard benefits, Gravie’s package includes alternative medicine coverage, flexible PTO, 16 weeks paid parental leave, paid holidays, cell phone reimbursement, education reimbursement, and 1 week of paid paw-ternity leave just to name a few.
