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Job Type
Full-time
Description
About Us:
Astiva Health, Inc. is a Medicare and HMO healthcare organization committed to delivering accessible, affordable, and high-quality care while improving outcomes for the diverse communities we serve. Through innovation, collaboration, and a strong focus on member-centered care, we strive to make a meaningful, lasting impact on healthcare delivery.
SUMMARY: The EZ-CAP Technician II provides operational and administrative support for EZ-CAP, EZ-NET, and EZ-CARE systems, focusing on user access, data updates, request intake, and task tracking under established procedures.
ESSENTIAL DUTIES AND RESPONSIBILITIES include the following:
- Performs advanced EZ-CAP configuration for contracts, benefits, fee schedules, and DOFRs.
- Builds, audits, and maintains benefit structures, amendments, and related code sets.
- Conducts claims testing, auditing, and troubleshooting to ensure configuration accuracy.
- Interprets contract requirements and translates them into system rules.
- Develops and executes test plans and validation documentation.
- Serves as escalation support for Technician I staff.
- Leads small configuration or optimization projects.
- Identifies system risks and improvement opportunities and recommends solutions.
- Maintains SOPs and configuration documentation.
- Mentors and provides technical guidance to Technician I staff.
- Coordinates with IT, Claims, Provider Relations, and Operations.
- Manages assigned work with minimal supervision.
- Performs other duties as assigned.
OTHER SKILLS and ABILITIES:
- Ability to learn quickly and follow new procedures and workflows.
- Team-oriented with strong attention to accuracy and documentation.
- Entry-level problem-solving skills with appropriate escalation.
- Able to communicate basic technical information effectively.
BENEFITS:
- 401(k)
- Dental Insurance
- Health Insurance
- Life Insurance
- Vision Insurance
- Paid Time Off
- Free catered lunches
Requirements
EDUCATION and/or EXPERIENCE:
- Bachelor's degree in healthcare, IT, or related field preferred but not required.
- 3-5 years of experience in Managed Care or healthcare-related roles.
- Advanced EZ-CAP knowledge required, including configuration, testing, and validation.
- Experience with claims adjudication, benefits, provider contracts, or system rule interpretation.
- Strong communication, analytical, and troubleshooting skills.
- Proficiency in Microsoft Office and project/task management tools.
- Ability to manage complex priorities independently and lead assigned initiatives
Salary Description
$33 - $40