Sr Developer
Spectraforce
US
Remote
7 hours ago
Job Description
Role: Sr Developer
Location: Remote
Duration: 6 months (possibility of extension)
Job description:
• Independently perform the analysis, design and development of high volume, low latency applications for mission critical systems delivering high-availability and performance to best meet customer needs.
• Write well designed, testable, efficient code to support varied and more complex IT solutions Provide strong technical expertise and collaborate with other IT specialists to rapidly develop and deliver stunning solutions that meet changing business needs.
• Perform all necessary discovery and fact finding to fully understand more complex business problems and opportunities and independently execute all assignments.
• Evaluate options and make solution buy vs. build recommendations to management when requested.
• Analyze and recommend solutions to development and production issues while effectively communicating to the project team, applicable vendors and/or the manager in a timely manner.
• Research and stay abreast of technology trends and IT best practices, with a focus on continuous learning and possible application to the business.
• Provide direction and assistance to less experienced team members.
• Experience in IBM ACE development is required
• Experience in IBM MQ, API development, XML, JSON, event-driven, Salesforce preferred.
Hiring Requirements:
• Bachelor's degree or advanced degree (where required)
• 5+ years of experience in related fields.
• In lieu of degree, 7+ years of experience in related field.
• Respond promptly and accurately to inquiries from Customer Service Professionals, subscribers, providers, physicians and other insurance carriers regarding claims payments.
• Meet or exceed established quality and performance standards
• Determine suspended claim resolution methods by reviewing benefit eligibility, claims history and other information
• Escalate claims requiring specialized resolution to subject matter experts based on department policies and guidelines to ensure the resolution
• Understand business requirements for the customer and provider segments with tailored solutions to their needs.
• Identify system issues by documenting the issue, recommend potential solution and refer appropriate technical staff
• Work with designated Provider Services specialists to deliver services tailored to the provider services
• Review claims for possible “fraud and abuse” and send to Special Investigations Unit for additional investigation
• Use continuous improvement and knowledge of claims to drive efficiency and production gains; share best practices
• Coordinate with other insurance carriers and Medicare to determine client’s payment liability
• Represent Claims interests on divisional or enterprise project teams
Top required skills:
• API Connect version 10
Nice to have skills:
• FHIR or HL7
• Integrations with EHR/EMR's like Epic
Industry Specific Experience:
• Healthcare
Breakdown of Duties/Typical Day:
• Getting requirements from the analysts on the team.
• Will be developing the end points through the APIv10 interface.
• Testing it then handing it over to the vendor or application developer to test.
• The delivery of the work would be expected within a 2-week timeframe from development to preprod.
Interview Process:
• Hour Panel with the hiring manager and a few other team members.
At SPECTRAFORCE, we are committed to maintaining a workplace that ensures fair compensation and wage transparency in adherence with all applicable state and local laws. This position’s starting pay is: $ 55.00/hr.
Location: Remote
Duration: 6 months (possibility of extension)
Job description:
• Independently perform the analysis, design and development of high volume, low latency applications for mission critical systems delivering high-availability and performance to best meet customer needs.
• Write well designed, testable, efficient code to support varied and more complex IT solutions Provide strong technical expertise and collaborate with other IT specialists to rapidly develop and deliver stunning solutions that meet changing business needs.
• Perform all necessary discovery and fact finding to fully understand more complex business problems and opportunities and independently execute all assignments.
• Evaluate options and make solution buy vs. build recommendations to management when requested.
• Analyze and recommend solutions to development and production issues while effectively communicating to the project team, applicable vendors and/or the manager in a timely manner.
• Research and stay abreast of technology trends and IT best practices, with a focus on continuous learning and possible application to the business.
• Provide direction and assistance to less experienced team members.
• Experience in IBM ACE development is required
• Experience in IBM MQ, API development, XML, JSON, event-driven, Salesforce preferred.
Hiring Requirements:
• Bachelor's degree or advanced degree (where required)
• 5+ years of experience in related fields.
• In lieu of degree, 7+ years of experience in related field.
• Respond promptly and accurately to inquiries from Customer Service Professionals, subscribers, providers, physicians and other insurance carriers regarding claims payments.
• Meet or exceed established quality and performance standards
• Determine suspended claim resolution methods by reviewing benefit eligibility, claims history and other information
• Escalate claims requiring specialized resolution to subject matter experts based on department policies and guidelines to ensure the resolution
• Understand business requirements for the customer and provider segments with tailored solutions to their needs.
• Identify system issues by documenting the issue, recommend potential solution and refer appropriate technical staff
• Work with designated Provider Services specialists to deliver services tailored to the provider services
• Review claims for possible “fraud and abuse” and send to Special Investigations Unit for additional investigation
• Use continuous improvement and knowledge of claims to drive efficiency and production gains; share best practices
• Coordinate with other insurance carriers and Medicare to determine client’s payment liability
• Represent Claims interests on divisional or enterprise project teams
Top required skills:
• API Connect version 10
Nice to have skills:
• FHIR or HL7
• Integrations with EHR/EMR's like Epic
Industry Specific Experience:
• Healthcare
Breakdown of Duties/Typical Day:
• Getting requirements from the analysts on the team.
• Will be developing the end points through the APIv10 interface.
• Testing it then handing it over to the vendor or application developer to test.
• The delivery of the work would be expected within a 2-week timeframe from development to preprod.
Interview Process:
• Hour Panel with the hiring manager and a few other team members.
Applicant Notices & Disclaimers
- For information on benefits, equal opportunity employment, and location-specific applicant notices, click here
At SPECTRAFORCE, we are committed to maintaining a workplace that ensures fair compensation and wage transparency in adherence with all applicable state and local laws. This position’s starting pay is: $ 55.00/hr.