You will design, develop, and maintain software applications within the healthcare billing and enrollment systems. This role involves collaborating with architects, mentoring junior engineers, and participating in Agile scrum teams to deliver high-quality software solutions.
SKYGEN
6 Remote Job Openings at SKYGEN
Perform regular audits of authorization case work to ensure compliance with regulatory requirements and service level agreements. Provide technical support and system configuration assistance to clinical and administrative teams while identifying root causes for processing errors.
The role involves providing administrative support to the authorizations team by reviewing dental insurance authorizations and ensuring submission accuracy. You will also maintain detailed records, communicate with provider offices to obtain clinical information, and assist with audits and denial processing.
The Business Analyst will collaborate with stakeholders to identify, document, and translate business requirements into effective solutions. They will also lead meetings, manage project timelines, and perform root cause analysis to drive process improvements.
Handle inbound calls for dental and vision insurance regarding eligibility, benefits, and claims. Act as a liaison between the organization and member services to resolve provider and member issues.
Oversee the credentialing department to ensure providers are credentialed accurately and timely while serving as a subject matter expert in commercial insurance. Lead and develop staff, implement departmental procedures, and ensure alignment with NCQA and regulatory guidelines.