Job Opportunities API

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