Sr Capability Analyst

We are seeking a motivated and detail-oriented individual to join our team as a Sr Capability Analyst. This position offers the opportunity to lead and support critical claim projects in a dynamic work environment.

Responsibilities

• Lead initiatives to mitigate known claim issues and resolve escalations effectively.
• Gather and document claims processing requirements in alignment with business partner needs.
• Evaluate and recommend solutions that minimize costs while meeting operational requirements.
• Communicate testing scenarios and provide feedback on execution gaps.
• Draft policies and procedures for claim processing based on state partner requests.
• Train operations teams on new processes and system capabilities.
• Conduct audits using SQL reports to validate claims processing outcomes.

Skills

• Proficient in Microsoft Office Suite, particularly Excel, Word, and Visio.
• 3+ years of experience with CSP Facets Claims Platform.
• Strong analytical and problem-solving skills in a customer-focused environment.
• Moderate proficiency in computer applications and the ability to learn new systems quickly.

Preferred Skills

• Expertise in Medicaid and DSNP Claims Domain.
• Experience capturing requirements in a healthcare setting.
• Knowledge of claims processing best practices.
• Associate’s Degree or higher in a related field.

We believe in fostering a diverse, equitable, and inclusive workplace where every team member's contributions are valued. We encourage individuals from all backgrounds to apply and join us in creating a supportive environment.

Once you apply for this position, you may receive a phone call, SMS or email at the time of application from our Virtual AI Recruiter, Alex, to conduct an initial interview.

Horizontal facilitates valuable and productive conversations between you and potential employers. We can assist you in growing your career by partnering you with employers that offer challenging assignments. For those that join the team, we offer competitive compensation and benefits including medical, dental, vision, and retirement. Check out all we have to offer and how you can become part of the Horizontal Talent Team. The pay range for this role is $20 - $48 per hour. This is not a guarantee of compensation, as final offer amount may vary based on factors including but not limited to experience and geographic location.