Opportunities

Developer and EDI Analyst

As a key member of the technology team, the Developer and EDI Analyst will be responsible for working with our EDI partners, writing requirements, developing, mapping and integrating with SQL Server. The person in this role also will create complex database reports based on end user specifications, provide analytical and technical support for complex requests, manipulate data and present it in an appropriate format, gather report objectives, extract data, run reports from our existing library and create new or modify existing reports as appropriate. The Developer and EDI Analyst will also work with the Senior Application Developer to improve and enhance both custom applications and coding solutions that integrate with third party applications. The person in this role will be supervised by the Senior Application Developer, while working very closely with the Director of Information Technology.

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Developer and EDI Analyst

Location:
Horsham, PA
Status:
Full Time
Shift:
Day
Supervisory:
No
Travel:
Occasional

About the Organization:

The Delaware Valley Health Trust (DVHT) provides comprehensive health benefits to over 20,000 employees and dependents of public entities located throughout Pennsylvania and Delaware. DVHT is part of Delaware Valley Trusts, which is a fast growing organization that also provides property and liability coverage and workers’ compensation coverage to its municipal members via the Delaware Valley Property & Liability Trust and Delaware Valley Workers’ Compensation Trust. Our offices are conveniently located in Horsham, PA. The Delaware Valley Trusts are distinguished by generally providing broader coverage and exemplary claims and member service, including a wide range of value-added benefits, workshops and training opportunities for employees of its members.

Position Summary:

As a key member of the technology team, the Developer and EDI Analyst will be responsible for working with our EDI partners, writing requirements, developing, mapping and integrating with SQL Server. The person in this role also will create complex database reports based on end user specifications, provide analytical and technical support for complex requests, manipulate data and present it in an appropriate format, gather report objectives, extract data, run reports from our existing library and create new or modify existing reports as appropriate. The Developer and EDI Analyst will also work with the Senior Application Developer to improve and enhance both custom applications and coding solutions that integrate with third party applications. The person in this role will be supervised by the Senior Application Developer, while working very closely with the Director of Information Technology.

Essential Duties and Responsibilities of the Position:

  • Work with our EDI partners, writing requirements, developing, mapping and integrating with SQL Server
  • Work with our internal IT team to assist with maintenance activities for our existing internal applications, including fixes, troubleshooting, monitoring and enhancements
  • Automate and optimize data transfer, online reports, and presentations for internal and external clients
  • Create complex database reports based on end user specifications
  • Provide analytical and technical support for complex requests
  • Manipulate data and present it in an appropriate format
  • Gather report objectives, extract data, run reports from our existing library and create new or modify existing reports as appropriate
  • Code and design applications based upon detailed specifications of business and end-user requirements
  • Maintain data integrity and security in applications
  • Identifies and adopts new development methodologies, best practices, and tools
  • Log effort and work into tracking system for traceability
  • Regular, dependable attendance and punctuality

Qualifications:

Bachelor’s degree in Computer Science or related field from an accredited institution or equivalent experience

  • Minimum of 2 years of experience with SQL Server and Data Report Development, which must include strong technical skills in report writing and reporting tools, such as Microsoft Visual Studio, SSRS, Crystal and Business Objects
  • Experience with Electronic Data Interchange (EDI) version standards, transaction sets, and SSIS is preferred
  • Working knowledge of relational database concepts and commonly-used concepts, practices, and procedures within software development
  • Experience coding in Visual Basic, ASP.net, C#, JavaScript and Bootstrap is preferred
  • Ability to define problems, collect data, establish facts, and draw valid conclusions that demonstrate good judgment
  • Strong organization skills, including ability to multi-task and prioritize multiple assignments
  • Ability to work both independently and collaboratively in a small team environment
  • Ability to focus and pay keen attention to detail
  • Ability to work in a complex environment that involves many dependencies and understand how a change to any one piece may affect others
  • Strong written and verbal communication skills

Compensation and Benefits:

We offer a competitive salary commensurate with education and experience, along with many employer-paid benefits. Our comprehensive benefits package includes life insurance, health insurance, dental insurance, vision insurance, flexible spending accounts, defined benefit retirement plan, defined contribution retirement plan, generous paid time off, short and long-term disability coverage, tuition assistance and other training and professional development opportunities. Our office dress code is business casual.

Equal Opportunity Employer:

The Delaware Valley Trusts are committed to equal employment opportunity and compliance with all laws and regulations pertaining to it. Our policy is to provide employment, training, compensation, promotion, and other conditions or opportunities of employment, without regard to race, color, religion, age, sex, sexual orientation, transgender, national origin, disability, genetic information, veteran or marital status, or any other characteristic protected by law.

How to Apply: If you are interested in exploring this career opportunity, please submit a resume, cover letter and salary requirements to careers@dvtrusts.com. Please include “Developer and EDI Analyst” in the email subject line.

 

 

Health Claims Specialist

In this position created due to growth, the Health Claims Specialist will facilitate accurate responses to member and enrollee inquiries regarding benefits, claims, billing, eligibility, coverage and other related information via phone and email.

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Health Claims Specialist

About the Organization:

The Delaware Valley Health Trust (DVHT) provides comprehensive health benefits to employees and dependents of public entities located throughout Pennsylvania and Delaware. DVHT uses Aetna as its third party administrator to adjudicate claims yet maintains its own internal claims staff to assist with member inquiries and provide exceptional customer service. DVHT is part of the Delaware Valley Trusts, which is a fast growing organization that also provides property and liability coverage and workers’ compensation coverage to its municipal members via the Delaware Valley Property and Liability Trust and Delaware Valley Workers’ Compensation Trust. Our offices are conveniently located in Horsham, PA. The Delaware Valley Trusts are distinguished by generally providing broader coverage and exemplary claims and member service, including a wide range of workshops and training opportunities for employees of its members.

Essential Duties and Responsibilities of the Position:

  •  Research and resolve coding, billing and payment related issues with respect to medical, prescription drug, dental and vision claims, including but not limited to office visits, inpatient and outpatient procedures, diagnostic imaging, medical equipment and preventive care
  • Explain cost-sharing concepts related to medical, prescription drug, dental and vision claims, including but not limited to office visits, inpatient and outpatient procedures, diagnostic imaging, medical equipment and preventive care
  • Identify and resolve coordination of benefits issues with Medicare and insurance companies
  • Utilize computer-based resources in a highly effective manner to educate and provide accurate responses to member, enrollee and internal inquiries
  • Review insurance coverage documents, including summary plan descriptions, summaries of benefits and coverage, and clinical policy bulletins
  • Identify and communicate in-network primary care or specialist physicians in a geographical area or particular specialty
  • Special projects as assigned
  • Return all phone calls and emails promptly to ensure excellent customer service is provided to enrollees and members
  • Regular, dependable attendance and punctuality

Qualifications:

High school diploma is required; associate’s or bachelor’s degree is preferred

  • 5+ years of customer service experience analyzing and solving customer problems required; call center experience a plus
  • Ability to interact with members and colleagues in a professional, friendly and patient manner
  • In-depth understanding of medical coding and billing
  • Previous claims experience with a health insurance issuer or third party administrator is highly desired
  • Understanding of and ability to review insurance coverage documents, including summary plan descriptions, summaries of benefits and coverage, and clinical policy bulletins
  • Ability to work independently and in a small group setting
  • Strong analytical, investigative and problem-solving skills
  • Strong written and verbal communication skills
  • Strong computer skills (Microsoft Office is essential)
  • Strong organizational skills and ability to multitask

Compensation and Benefits:

We offer a competitive salary commensurate with education and experience, along with a comprehensive benefits package including life, health, dental, vision, flexible spending accounts, defined benefit retirement plan, deferred compensation plan, paid time off, short and long-term disability coverage, tuition assistance and other training and professional development opportunities. Our office dress code is business casual.

Equal Opportunity Employer:

The Delaware Valley Trusts are committed to equal employment opportunity and compliance with all laws and regulations pertaining to it. Our policy is to provide employment, training, compensation, promotion, and other conditions or opportunities of employment, without regard to race, color, religion, age, sex, sexual orientation, transgender, national origin, disability, genetic information, veteran or marital status, or any other characteristic protected by law.

How to Apply: If you are interested in exploring this career opportunity, please submit a resume, cover letter and salary requirements to careers@dvit.com. Please include “Health Claims Specialist” in the email subject line.