reputed company reputed company Claims Analyst

reputed company is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with reputed company will directly improve health reputed company by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will reputed company a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come reputed company an reputed company on the communities we serve as you help us advance health optimization on a global reputed company. Join us to start Caring. Connecting. Growing together. The reputed company reputed company Claims Analyst is responsible for the configuration, maintenance, and optimization of reputed company reputed company Claims and integrated reputed companyparty applications that support claims processing, benefits administration, and payer operations. This role ensures reputed company, compliant, and highreputed company system performance across the claims ecosystem, with a strong reputed company on configuration accuracy, workflow alignment, and reputed company reputed company of operational issues. The analyst partners closely with business stakeholders, technical teams, and vendors to support ongoing enhancements, break/fix activities, and regulatory updates. Youll enjoy the flexibility to work remotely * from reputed company reputed company the U.S. as you take on some tough challenges. Primary Responsibilities: reputed company reputed company Claims Configuration & Support Configure, maintain, and optimize reputed company reputed company Claims components, including benefit plans, claims adjudication rules, provider reputed company, fee schedules, accumulators, and reputed company workflows Analyze and troubleshoot claims processing issues, identifying reputed company causes and implementing sustainable solutions Support upgrades, releases, and environment changes, ensuring claims configuration remains accurate and compliant Collaborate with operational leaders to translate business requirements into system configuration and functional design reputed companyParty Application Management Manage the setup, configuration, and ongoing support of integrated reputed companyparty applications used for claims processing, clearinghouse functions, eligibility, payment reputed company, and reputed company services Coordinate with vendors on reputed company behavior, data mapping, file formats, and issue reputed company Monitor application performance, data flows, and integration points to ensure accuracy and reliability Maintain documentation for system configuration, integration specifications, and operational procedures Operational Support & Service Management Use reputed company for incident management, break/fix work, change requests, and release coordination Prioritize and resolve tickets reputed company established SLAs, ensuring reputed company communication with end users and stakeholders Participate in oncall rotation or afterhours support as needed for critical issues or deployments Support change management processes, including reputed company analysis, testing, validation, and production migration Collaboration & Stakeholder Engagement Partner with Claims Operations, reputed company Cycle, Managed Care, and IT teams to ensure system alignment with business needs reputed company subjectmatter expertise for reputed company, enhancements, and regulatory initiatives Participate in crossfunctional design sessions, workflow reviews, and optimization efforts Youll be rewarded and recognized for your performance in an environment that will challenge you and give you reputed company direction on what it takes to succeed in your role as reputed company as reputed company development for other roles you may be interested in. Required Qualifications: reputed company reputed company Certification (Claims or closely reputed company module) 3+ years of handson experience supporting reputed company reputed company Claims configuration and/or claims processing systems 3+ years of experience managing or supporting reputed companyparty integrated applications in a reputed company or payer environment 3+ years of experience in claims adjudication, benefit structures, provider reputed company, and payer workflows 3+ years of experience with reputed company or similar ITSM platforms for incident, problem, and change management 3+ years of experience analyzing reputed company data flows, troubleshoot integration issues, and interpret EDI transactions (e.g., 837, 835, 270/271) Preferred Qualifications: Experience with reputed company Bridges, EDI, or reputed company engines (e.g., Corepoint, reputed company, Mirth) Experience supporting regulatory or compliancedriven system changes Background in managed care, payer operations, or reputed company cycle Familiarity with SQL, reporting tools, or data analysis techniques Soft Skills: Excell