UST

  • Columbus, OH, USA
UST Remote * (Columbus, OH, USA)
Sep 16, 2021
Senior Claims Examiner/Auditor UST HealthProof is looking for Sr. Claims Examiner, reporting to the Claims Team Leader; the Examiner is responsible for the adjudication of healthcare claims utilizing group and payer-specific policies and procedures. Responsible for reviewing the data in the claims processing system and compare with corresponding UB04 or CMS1500. Responsible for reviewing claims attachments when necessary to determine if services rendered were medically appropriate and benefit coverage criteria have been met. Accountable for reviewing adjudication software system's claim and line item edits to decide whether to pay claim/line item(s). As a Sr. Claims Examiner at UST HealthProof, this is your opportunity to • Be responsible for attending and completing the training scheduled by the client and employer. • Be responsible for processing assigned claims based on client-specified guidelines or as directed by the team lead • Be responsible for...
UST Remote * (Dallas, TX, USA)
Sep 14, 2021
Senior Claims Examiner UST HealthProof is looking for Sr. Claims Examiner, reporting to the Claims Team Leader, the Examiner is responsible for adjudication of healthcare claims utilizing employer and payer specific policies and procedures. Responsible for reviewing the data in the claims processing system and compare with corresponding UB04 or CMS1500. Responsible for reviewing claims attachments when necessary to determine if services rendered was medically appropriate and benefit coverage criteria has been met. Responsible for reviewing adjudication software system's claim and line items edits for determination of whether to pay claim/line item(s). As a Sr. Claims Examiner at UST HealthProof, this is your opportunity to • Be responsible for attending and successfully completing the trainings scheduled by the client and employer • Be responsible for processing assigned claims based on client specified guidelines or as directed by team lead • Be...
UST Remote * (Aliso Viejo, CA, USA)
Sep 12, 2021
UST HealthProof is looking for a highly energetic and collaborative Data Architect with experience working on enterprise data projects around Business and IT operations. The ideal candidate should have expert knowledge in Qlik/Attunity Compose and Replicate . Candidate should have good experience in defining the overall technical architecture for enterprise and customer data platforms. A good understanding of enterprise data architecture and systems is expected. Excellent written and verbal communication skills. Qilck Replicate_ Architect/Technical Lead Remote with Some Travel Fulltime/W2/Permanent role with UST You bring: Experience with Qlik/Attunity Replicate and Qlik/Attunity Compose Architect for ODS with expertise on Attunity Replicate and Compose Overall Experience level: 5+ years in IT as an architect with min 2+ years as an Attunity architect Bachelor's degree in Computer Science, Computer Engineering or a software related discipline. A Master's...
UST Remote * (Aliso Viejo, CA, USA)
Sep 12, 2021
Role Proficiency: Perform end-to-end management of a single project up to TCV of 500K with time and effort based or deliverable based model; by delivering the agreed scope within the agreed timeline and cost. Ensure the success and acceptance criteria of the project are met enhancing customer satisfaction. Outcomes: Identify key stakeholders ensuring establishment and maintaining positive business relationships among stakeholders (internal or external) Maintain regular communication with customer; addressing needs through empathy with their environment Define activities responsibilities critical milestones resources skills needs interfaces and budget. Optimize costs and time utilisation minimize waste and deliver projects on time on budget as per the contract and agreed scope with a high quality result. Anticipate all possible risk manage them by applying the suitable risk management strategy; while developing contingency plans. Implement the governance model...
UST Remote * (Indianapolis, IN, USA)
Sep 12, 2021
Senior Claims Examiner UST HealthProof is looking for Sr. Claims Examiner, reporting to the Claims Team Leader. This position is responsible for adjudication of healthcare claims utilizing employer and payer specific policies and procedures. This includes responsibility for reviewing the data in the claims processing system and comparing data with corresponding UB04 or CMS1500, reviewing claims attachments when necessary to determine if services rendered are medically appropriate and benefit coverage criteria has been met, and reviewing adjudication software system's claim and line items edits for determination of whether to pay or deny claim/line item(s). As a Sr. Claims Examiner with UST HealthProof this is your opportunity to : • Attend and successfully complete required training scheduled by both the client and employer • Process and adjust assigned claims based on client specified guidelines or as directed by the Team Lead. • Meeting complex claims...
UST Remote * (Dallas, TX, USA)
Sep 09, 2021
Claims Team Lead UST HealthProof is looking for a highly energetic and collaborative Claims Team Lead with 5-7+ years of operation experience, out of which 2+ years in supervisory role. This role will report into the Operations Manager or as designated by the Director of Operations for Healthcare Platform Solutions. Candidate should have Excellent written and verbal communication skills and ability to liaise with client organizations and multiple stakeholders to be successful in this role. The primary objective of The Claims Leader is to implement policies and procedures to foster an environment of excellence in servicing UST HealthProof Healthcare Customers. This includes leading and managing a team of 12-15 claims examiners, adjusters, extensive interaction with client organization and multiple stakeholders, delivering a high-quality claims operation meeting and exceeding all service level agreements and KPIs, driving operational excellence and building competencies...
UST Remote * (Westborough, MA, USA)
Aug 29, 2021
Advalent Inc (a wholly-owned subsidiary of UST HealthProof Inc .) is looking for a Lead Java development, who under the general supervision of the Engineering Platform Delivery Manager, Business leads and Delivery Lead, will work to deliver the implementation of a Health care ecosystem for our Health Plan clients. The Lead, Java developer will work with the small to mid-size Health Plan Clients, third party vendors, and onshore and offshore associates to develop healthcare file interchange systems, EDI systems, Claims adjudication engines, report engines and other back-end systems. Candidate should have excellent technical and communication skills and ability to engage as part of a team working both physically together and virtually. You should be an excellent problem solver who is able to grasp customer needs and brainstorm ways to fulfill them. You should be a servant leader and should have the ability to lead from the front. This will be an 70% hands-on position and 30%...
UST Remote * (Louisville, KY, USA)
Aug 27, 2021
Company UST is a leading provider of platforms, digital innovation, artificial Intelligence and end-to-end IT & Business services and solutions for Global 1000 companies. We are transforming corporations through deep domain expertise, knowledge-based ML platforms, as well as profound anthropological efforts to understand the end customer and design products and interactions that create delight. We are deeply committed to developing a comprehensive understanding of our clients' problems and to develop platforms to address them. Java Solution Architect with Microservice Fulltime/Directhire with UST Louisville, KY (Prefer candidate work onsite after remote,if Candidate is looking for complete/100% remote after pandemic/Covid will consider that ) Description: The main function of a Solutions Architect is to provide solutions architecture oversight for new development projects according to timelines and budget, while following accepted programming, testing and change...