Lead business requirement conversations with customers and internal teams.
Develop business and functional requirements for Claims, Enrollment, Provider, Authorization, and Payment systems.
Collaborate with business users, management, IT, and offshore staff using Agile methodology.
UST HealthProof is a company focused on reshaping the future of health insurance by reducing administrative costs and building better healthcare experiences. It is run by leaders with strong health plan and technology backgrounds, fostering a start-up mindset and supportive environment where individual growth is nurtured.
Troubleshoot complex issues related to the Patient Access Curator platform and payer configurations.
Manage a large caseload of escalated support cases via Salesforce, email, and phone.
Collaborate with internal teams, payers, and clients to resolve issues and oversee small projects.
Experian is a global data and technology company that powers opportunities for people and businesses worldwide, using data, analytics, and software across markets like financial services and healthcare. With 23,300 employees across 32 countries and a people-first culture, they are a FTSE 100 company recognized as a top workplace.
Provide strategic leadership and operational execution for clearinghouse and payer-facing transaction services.
Ensure performance, availability, and regulatory compliance of EDI transactions connecting providers and payers.
Drive operational excellence, automation, and client outcomes using Experian’s data and analytics.
Experian is a global data and technology company powering opportunities for people and businesses across financial services, healthcare, and other markets. They have an inclusive, people-first culture and a team of 25,200 people in 32 countries.
Facilitate client calls related to contracting and payer enrollments.
Run and analyze client KPIs, providing regular reports.
Manage the full contracting and payer enrollment process.
Experity transforms on-demand healthcare across the U.S. by empowering urgent care clinics with industry-leading software. The company fosters a team-first culture with opportunities for flexible work and career development.
Lead end-to-end interoperability programs supporting Risk Adjustment and payor-provider data exchange.
Develop and manage relationships with provider organizations and external stakeholders to ensure effective data connectivity.
Build, maintain, and enhance project plans, dashboards, and operational strategies to drive measurable program impact.
Our partner is a technology-driven healthcare company focused on improving data connectivity and interoperability between provider systems and payor networks. They operate in a fast-moving environment with a remote team, emphasizing high-impact initiatives and cross-functional collaboration.
Attend new client implementation meetings to discuss eligibility requirements and protocols.
Serve as a point of coordination for member eligibility issue identification and resolution with internal teams and external partners.
Proactively monitor system status and eligibility data to identify potential abnormalities impacting quality and accuracy.
Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including pharmacy benefit management and health benefit management. They are rebuilding trust in healthcare in the U.S. and value a diverse workplace, providing equal employment opportunities to all employees.