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CareSource

Claims Management Analyst III

CareSource, Myrtle Point, Oregon, United States, 97458

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Employer Industry: Healthcare Insurance

Why consider this job opportunity

Salary up to $113,200.00

Opportunity for bonuses tied to company and individual performance

Comprehensive total rewards package focused on employee well‑being

Chance to lead and influence eBusiness initiatives across multiple functional areas

Collaborative workplace culture that promotes professional development

Engage in continuous improvement of EDI business processes

What to Expect (Job Responsibilities)

Manage EDI trading partners and ensure accurate and timely information exchange

Collaborate with Vendor Management to enhance trading partner agreements and reduce costs

Provide Subject Matter Expertise on eBusiness specific EDI transactions across departments

Analyze current processes and systems to identify areas for improvement and implement solutions

Develop and maintain partnerships with trading partner account representatives

What is Required (Qualifications)

Bachelor’s degree or equivalent years of relevant work experience

Minimum of five (5) years of healthcare operations experience in insurance, managed care, or a related industry

Advanced knowledge of healthcare EDI files (837, 277CA, 999, 270/271, 276/277)

Exceptional communication skills, both verbal and written, with a high level of professionalism

Strong analytical skills, including data analysis and trending abilities

How to Stand Out (Preferred Qualifications)

Experience with claims processing, including claims rejections and denial processes

Proven ability to work independently and collaboratively within a team environment

Strong leadership and relationship-building skills

Experience in developing user stories for sprint planning

Familiarity with managed care and health claims processing

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