Note: The job is a remote job and is open to candidates in USA. Gravie is a company focused on creating health benefits that truly benefit small and midsize businesses and their employees. They are seeking a Technical Analyst focused on Claims Automation to drive auto-adjudication and workflow optimization by identifying manual claim scenarios and designing systemic solutions.
Responsibilities
- Identify high-volume manual claim scenarios and evaluate opportunities for automation
- Design and implement automation enhancements within the claims processing system
- Partner with engineering and vendors, including Mphasis, to expand systemic and auto-adjudication capabilities
- Analyze claims workflows and system logic to identify inefficiencies and recommend improvements
- Translate business requirements into technical solutions aligned with claims processing standards
- Document automation workflows, business rules, and system configurations
- Monitor auto-adjudication performance metrics and identify opportunities to improve turnaround time and accuracy
- Support testing and validation of system changes and automation enhancements
- Demonstrate commitment to our core competencies of being authentic, curious, creative, empathetic, and outcome oriented
- Support EDI workflows and troubleshoot transaction issues including 837 claim submissions and 835 remittance files in partnership with the EDI team
Skills
- 3+ years of experience in claims systems, business analysis, or healthcare IT
- Understanding of claims adjudication processes and system workflow logic
- Working knowledge of SQL or similar tools for analyzing data and system performance
- Experience identifying and implementing process automation or system enhancements
- Ability to translate complex business problems into technical requirements
- Strong analytical and problem-solving skills with attention to detail
- Experience working cross-functionally with engineering, operations, and vendor partners
- Familiarity with Javelina or similar claims processing platforms
- Working knowledge of EDI formats (837/835) and medical coding systems
- Experience with vendor management and SLA monitoring
- Previous startup or high-growth company experience
Benefits
- Alternative medicine coverage
- Flexible PTO
- Up to 16 weeks paid parental leave
- Paid holidays
- A 401k program
- Transportation perks
- Education reimbursement
- 2 days of paid paw-ternity leave
Company Overview
Company H1B Sponsorship