Technical Analyst - Claims Automation

Summary

Gravie is a company focused on creating health benefits that truly benefit small and midsize businesses and their employees. They are seeking a Technical Analyst focused on Claims Automation to drive auto-adjudication and workflow optimization by identifying manual claim scenarios and designing systemic solutions.

Responsibilities

• Identify high-volume manual claim scenarios and evaluate opportunities for automation
• Design and implement automation enhancements within the claims processing system
• Partner with engineering and vendors, including Mphasis, to expand systemic and auto-adjudication capabilities
• Analyze claims workflows and system logic to identify inefficiencies and recommend improvements
• Translate business requirements into technical solutions aligned with claims processing standards
• Document automation workflows, business rules, and system configurations
• Monitor auto-adjudication performance metrics and identify opportunities to improve turnaround time and accuracy
• Support testing and validation of system changes and automation enhancements
• Demonstrate commitment to our core competencies of being authentic, curious, creative, empathetic, and outcome oriented
• Support EDI workflows and troubleshoot transaction issues including 837 claim submissions and 835 remittance files in partnership with the EDI team

Skills

• 3+ years of experience in claims systems, business analysis, or healthcare IT
• Understanding of claims adjudication processes and system workflow logic
• Working knowledge of SQL or similar tools for analyzing data and system performance
• Experience identifying and implementing process automation or system enhancements
• Ability to translate complex business problems into technical requirements
• Strong analytical and problem-solving skills with attention to detail
• Experience working cross-functionally with engineering, operations, and vendor partners
• Familiarity with Javelina or similar claims processing platforms
• Working knowledge of EDI formats (837/835) and medical coding systems
• Experience with vendor management and SLA monitoring
• Previous startup or high-growth company experience

Qualifications

Must Haves

• 3+ years of experience in claims systems, business analysis, or healthcare IT
• Understanding of claims adjudication processes and system workflow logic
• Working knowledge of SQL or similar tools for analyzing data and system performance
• Experience identifying and implementing process automation or system enhancements
• Ability to translate complex business problems into technical requirements
• Strong analytical and problem-solving skills with attention to detail
• Experience working cross-functionally with engineering, operations, and vendor partners

Nice to Haves

• Familiarity with Javelina or similar claims processing platforms
• Working knowledge of EDI formats (837/835) and medical coding systems
• Experience with vendor management and SLA monitoring
• Previous startup or high-growth company experience

Benefits

• Alternative medicine coverage
• Flexible PTO
• Up to 16 weeks paid parental leave
• Paid holidays
• A 401k program
• Transportation perks
• Education reimbursement
• 2 days of paid paw-ternity leave