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:
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Performs advanced EZ-CAP configuration for contracts, benefits, fee schedules, and DOFRs.
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Builds, audits, and maintains benefit structures, amendments, and related code sets.
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Conducts claims testing, auditing, and troubleshooting to ensure configuration accuracy.
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Interprets contract requirements and translates them into system rules.
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Develops and executes test plans and validation documentation.
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Serves as escalation support for Technician I staff.
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Leads small configuration or optimization projects.
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Identifies system risks and improvement opportunities and recommends solutions.
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Maintains SOPs and configuration documentation.
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Mentors and provides technical guidance to Technician I staff.
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Coordinates with IT, Claims, Provider Relations, and Operations.
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Manages assigned work with minimal supervision.
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Performs other duties as assigned.
OTHER SKILLS and ABILITIES:
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Ability to learn quickly and follow new procedures and workflows.
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Team-oriented with strong attention to accuracy and documentation.
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Entry-level problem-solving skills with appropriate escalation.
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Able to communicate basic technical information effectively.
BENEFITS:
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401(k)
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Dental Insurance
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Health Insurance
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Life Insurance
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Vision Insurance
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Paid Time Off
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Free catered lunches
Requirements:
EDUCATION and/or EXPERIENCE:
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Bachelor’s degree in healthcare, IT, or related field preferred but not required.
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3–5 years of experience in Managed Care or healthcare-related roles.
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Advanced EZ-CAP knowledge required, including configuration, testing, and validation.
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Experience with claims adjudication, benefits, provider contracts, or system rule interpretation.
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Strong communication, analytical, and troubleshooting skills.
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Proficiency in Microsoft Office and project/task management tools.
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Ability to manage complex priorities independently and lead assigned initiatives
