Growth opportunities to uplevel your careerA people-centric culture embracing and celebrating diverse perspectives, backgrounds, and experiences within our teamCompetitive compensation and comprehensive benefits focused on well-beingAn opportunity to shape the future of health care by joining a team recognized as a Best Place to Work For in the NY Capital District , one of the Best Companies to Work For in New York , and an Inclusive Workplace .
Qualifications you'll bring:
Associate degree preferred (or equivalent relevant work experience).
The availability to work full-time, remote within NYS.
Medical claims processing analysis skills with strong attention to detail and quality control focus.
3+ years of experience in a related field (accumulator data exchanges and/or health insurance claims processing) preferred.
3+ years of experience using Microsoft Word and Excel preferred.
Critical thinking and problem-solving/troubleshooting skills; able to analyze information, multi-task, prioritize, and adapt in a changing environment.
Curiosity to foster innovation and pave the way for growth
Humility to play as a team
Commitment to being the difference for our customers in every interaction
Your key responsibilities:
Partner with Sales/Marketing, Pharmacy, Claims Operations, and other business units to communicate and resolve accumulator issues aligned with organizational strategy and values.
Investigate and resolve accumulator-related issues tied to medical, pharmacy, and behavioral health claims using Facets and Macess systems while meeting assigned project goals.
Review, analyze, and evaluate accumulator errors using existing and new data reports; identify root causes and trends, document resolutions, and opportunities for process improvement.
Respond to member service calls and inquiries regarding accumulator inquiries, coordinate resolution with impacted internal departments and MVP partners.
Document information in the appropriate location; participate in meetings on accumulator objectives, issues, and progress; help maintain current training and process documentation.
Run and interpret reports to identify impacted claims, dollar volume, and group/member impact; proactively identify process and efficiency opportunities for accumulator data transmissions.
Participate in upper management meetings as needed to provide status updates, communicate risks and impacts, and present findings and recommendations clearly and professionally to internal stakeholders and vendors, as needed.
Contribute to our humble pursuit of excellence by performing various responsibilities that may arise, reflecting our collective goal of enhancing healthcare delivery and being the difference for the customer.
Where you'll be:
Remote within NYS
Pay Transparency
We do not request current or historical salary information from candidates.
$24.00-$31.92
MVP's Inclusion Statement
MVP is an equal opportunity employer and recruits, employs, trains, compensates, and promotes without discrimination based on race, color, creed, national or
Health insurance
Remote work options
Equity / stock options
Additional Information
Join Us in Shaping the Future of Health Care
At MVP Health Care, we're on a mission to create a healthier future for everyone. That means embracing innovation, championing equity, and continuously improving how we serve our communities. Our team is powered by people who are curious, humble, and committed to making a difference-every interaction, every day. We've been putting people first for over 40 years, offering high-quality health plans across New York and Vermont and partnering with forward-thinking organizations to deliver more personalized, equitable, and accessible care. As a not-for-profit, we invest in what matters most: our customers, our communities, and our team.
Mvphealthcare · Remote