Technical Analyst - Claims Automation
Hi, we’re Gravie. Our mission is to create health benefits that actually benefit small and midsize businesses and their employees. Our innovative benefit solutions and services are developed and delivered by a diverse group of unique people. We encourage you to be your authentic self - we like you that way.
A Little More About This Role
We’re looking for a Technical Analyst focused on Claims Automation to join our configuration team. In this role, you will drive auto-adjudication and workflow optimization by identifying manual claim scenarios and designing systemic solutions. You will partner closely with engineering, vendors, and internal teams to expand automated capabilities, increase efficiency, and lower cost per claim.
You Will
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
You Bring
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
Extra Credit
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
A Little More About Us:
We know healthcare. Our company was founded and is still led by industry veterans who have started and grown several market-leading companies in the space.
We have raised money from top tier investors who share the same long-term vision as we do of building an industry defining company that will endure over the long run. We are well capitalized.
Our clients love us. Customer satisfaction rates among employees using Gravie health plans consistently rank above 80% - nearly 40 points above the industry average.
Our culture is unique. We tend to be non-hierarchical, merit-driven, opinionated but kind people who thrive working in a high-performance, fast-paced environment. People at Gravie care deeply about making a positive impact in the lives of the people we serve.
Benefits
Our unique benefits program is the gravy, i.e., the special sauce that sets our compensation package apart. In addition to standard health and wellness benefits, Gravie’s package includes alternative medicine coverage, flexible PTO, up to 16 weeks paid parental leave, paid holidays, a 401k program, transportation perks, education reimbursement, and 2 days of paid paw-ternity leave.