Now is the time to join us!
At Virgin Pulse we value and celebrate diversity and we are committed to creating an inclusive environment for all employees. We believe in creating teams made up of individuals with various backgrounds, experiences, and perspectives. Why? Because diversity inspires innovation, collaboration, and challenges us to produce better solutions. But more than this, diversity is our strength, and a catalyst in our ability to #changelivesforgood.
Who are you?
The role of Claims Integration Specialist is primarily responsible for handling initial setup and on-going maintenance of claims data feeds. This role will collaborate closely with the Implementation team, Account Management, Client Delivery, and other Operation teams to support the claims lifecycle.
In this role you will wear many hats, but your knowledge will be essential in the following:
Maintain a strong working knowledge of Virgin Pulse products.
Work with Implementation, Account Management and Client Delivery to implement new claims file integrations into the Virgin Pulse platform.
Participate in data interchange meetings with claims data providers that may include file requirement reviews, mapping overviews, data analysis of issues and/or file testing.
Create and maintain requirement documentation that include business rules, file mapping and transformation process specifications for all inbound claim’s files.
Collaborate with Integrations and DSR teams to ensure claims integrations align to configuration and reporting needs.
Build claims file mappings to match agreed upon requirements.
Process and analyze claims files delivered to Virgin Pulse.
Engage in detailed analysis of data discrepancies to determine the source and resolution of errors.
Respond to and resolve routine requests and questions.
Develop, implement, and enhance processes to drive overall performance of claims integration.
Perform additional duties as requested.
You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
What you bring to the Virgin Pulse team
In order to represent the best of what we have to offer you come to us with a multitude of positive attributes including:
Bachelor’s degree in Business/Statistics/Information Science, or equivalent, in related discipline.
Have a good understanding of the healthcare payer space with a minimum of 3 years of claims experience preferred.
3-5 years of professional work experience in data management, information systems, data analytics.
Willingness to learn new tools that manipulate, analyze and visualize data.
Strong knowledge of MS Office suite, especially Excel, PowerPoint, and MS Project.
SQL preferred
You also take pride in offering the following Core Skills, Competencies, and Characteristics:
Strong technical aptitude
Excellent interpersonal and writing skills.
Strong organizational skills and detail orientation.
Required to work cross functionally with co-workers and with external channel partners.
Ability to work independently as well as part of a team.
Solid analytical and problem-solving skills.
A high level of professionalism and positive work behavior.