Address
Form of work
SalaryCurative is reimagining health insurance - with $0 out of pocket costs and by reducing barriers to people seeking care. Help us create a better healthcare experience for our members by making it easy & intuitive for them to access the care they need. We believe in a clear, simple health plan that allows our members to get zero-cost in-network care anytime they need it. We want to put healthcare back in the hands of the patient and clinicians, with a focus on preventative care. This is a full time, remote position.
Essential Functions:
- Set up Health Plan benefit and provider additions and/or changes
- Set up and maintain fee schedules for all providers (e.g. fixed price, percentage of billed charges, per Diem, Medicare, and Medicaid)
- Setup and maintain provider demographics (i. e. NPIs, Taxonomy, etc.)
- Mentor junior team members
Responsibilities:
- Curative is rapidly growing, and is raising the bar in what people expect from their health plan. We’re looking for someone who can think creatively, has attention to detail, and can help us scale an aggressively growing business by making sure plans are onboarded quickly and accurately.
- Through data analysis, identify how we can improve our plan configuration
- Assist with our migration to a new claims system
- Identify opportunities for automation to improve our processes, and work with our engineers to implement them
- Performs other duties as assigned
Required Experience
- Bachelor’s degree in Computer Science, Computer Engineering, or a related field
- 5 Years relevant experience in health care plans/benefits build
- Knowledge of coding (CPT, ICD-10, HCPCS, DRG, RBRBS, DSM-IV, UB04 Revenue codes and modifiers).
- Experience in physician office billing and coding and/or customer service preferred
- Knowledge of various pricing methodologies (Medicare, Medicaid, AWP, ASC Groups, Anesthesia Units, etc.).
- Ability to apply health care pricing methodologies in order to maintain provider fee schedules
- Knowledge of enrollments and eligibility load into a claims system
Preferred Additional Experience
- Knowledge of and experience with healthcare claims systems (VBA, preferably Health Edge)
- Experience with EDI transactions
- Comfort working with SQL, Databases, Data Analytics tools & Data Science and other cross functional teams
- A strong desire to make healthcare better, to be part of a big change in the health insurance market
This position is fully remote
