Network Integration Technical Analyst

This is a fully remote position, open to applicants in United States.

📋 Description

• Develop and oversee various functions within the Integrated Client Environment (ICE)

• Assist the Provider Network Integration team and the Luminare Health organization

• Proactively identify issues to reduce any negative effects on the Luminare Health business

• Collaborate with team members, Luminare Health departments, networks, and clients to resolve challenges

• Utilize SQL to query and analyze data

• Interpret documentation from external vendors and assist with claim routing and pricing processes

⛳️ Requirements

• High School diploma or equivalent is mandatory

• At least four years of experience in medical claims, provider maintenance, or network support settings

• Excellent organizational, collaborative, and interpersonal abilities

• Proficient troubleshooting and analytical skills

• Capability to read, comprehend, and interpret external vendor network documentation

• Familiarity with claim routing and pricing processes

• Ability to thrive in a fast-paced, customer-service-oriented environment

• Competence in effectively collaborating with team members, various Luminare Health departments, networks, and clients

• Skill in addressing issues and achieving resolution

• Exceptional verbal and written communication abilities

• Experience in using SQL for querying and analyzing data

• Strong proficiency in Excel

• Bachelor's Degree is preferred

• Familiarity with PowerSTEPP, HealthEdge, Facets, or similar claims payment/pricing systems is preferred

• Experience in a TPA and/or payer operation is preferred

• Understanding of EDI terminology and file structures (837/835/etc.) is preferred

• Strong capability to conduct root-cause analysis is preferred

• Knowledge of .NET or other programming/scripting languages, including experience with conditional business rules, decision logic, or automated claim processing workflows is preferred

🏝️ Benefits

• Health and wellness benefits

• 401(k) savings plan

• Pension plan

• Paid time off

• Paid parental leave

• Disability insurance

• Supplemental life insurance

• Employee assistance program

• Paid holidays

• Tuition reimbursement

• Other incentives

• Annual incentive bonus plan subject to the terms and conditions of the plan