Job Opportunities

• Provider Relations Representative - Irvine, CA
• Client Account Manager - Irvine, CA
• Sr Systems Engineer - Irvine, CA
• Sr. Software Engineer - Irvine, CA
• Sr. EDI Database Developer - Irvine, CA
• Team Lead - Irvine, CA
• Hospital Specialist - Irvine, CA
• Bill Review Specialist III - Irvine, CA
• Bill Review Specialist II - Irvine, CA
• Bill Review Specialist I - Irvine, CA
• Data Control Specialists - Irvine, CA

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Provider Relations Representative - Irvine, CA

Duties/Responsibilities:

• Acts as primary liaison between provider and StrataCare
• Responds to written and verbal provider inquiries relating to our bill review analysis
• Analyzes problems using problem solving methodology skills to determine root cause; communicates and implements solutions
• Refers to reference library of fee schedules, CPT, ICD9, HCPCS and other industry publications to research and support findings
• Provides the highest level of customer service to customers, whether these are current or prospective clients of the Company, vendors, staff, business partners or visitors
• Identifies training and system deficiencies and issues; reports to Manager
• Performs all duties in accordance with established Company goals

Qualifications:

• Five years previous experience in the workers' compensation industry, preferably in bill review
• Thorough understanding of healthcare cost containment industry
• Thorough knowledge of the State of California Labor Code and its rules and regulations
• Competency to utilize Company software and proficiency in Microsoft software applications and a willingness to learn new systems as necessary
• Superior verbal/written communication, interpersonal and customer service skills
• Effective at influencing and persuading individuals within other internal groups in order to accomplish objectives and ensure client satisfaction
• Excellent negotiation skills

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Client Account Manager - Irvine, CA

Duties/Responsibilities:

• The Client Account Manager is the primary liaison between StrataCare and its clients.
• The position is the primary "voice of the customer" within the organization by communicating customer needs and expectations, and ensuring these are met
• Advocates on behalf of clients and ensures excellent service delivery with respect to client implementation, championing system enhancements, researching client inquires, addressing client invoicing, training clients on systems use, and creating reporting as needed
• Maintaining and increasing revenue with existing clients, by building strategic relationships with client contacts, including introducing additional StrataCare products that can benefit the client
• Demonstrates a strong client focus, maintains a balanced position when confronted with client concerns; demonstrates sensitivity towards customer issues, while ensuring that StrataCare's policies, profitability and marketplace reputation are protected
• Is the primary liaison between Production, IT and the client

Qualifications:

• BA/BS or equivalent experience
• 5 years previous experience in the workers' compensation industry, preferably in bill review
• Thorough understanding of healthcare cost containment industry
• Superior verbal/written communication, interpersonal and customer service skills
• Effective at influencing and persuading individuals within other internal groups in order to accomplish objectives and ensure client satisfaction
• Strong analytical, problem-solving and presentation skills

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Senior System Engineer - Irvine, CA

Duties/Responsibilities:

• Design, manage, monitor, document, and maintain the network infrastructure and all networked systems including 90+ servers for all environments including development, QA, corporate, and ASP
• Perform as a senior member of the systems administration team to support the installation, optimization, integration, troubleshooting, backup, recovery, modification, and upgrading of IT systems and components to provide services that enable customers (both internal and external) to effectively apply IT to business requirements
• Develop and deploy methodologies for testing network performance and provide statistics/reports and supporting data
• Review reports and system logs of computer and peripheral equipment and take corrective action or make recommendations as necessary
• Manage, monitor, and maintain all areas of the backup routine including tape rotation, inventory, off-site tape storage, tape library maintenance (firmware updates), review backup logs for missed files, etc.

Qualifications:

• Bachelor's degree in Computer Science or equivalent technical degree
• Minimum of 4 years experience
• Production level experience in the support and design of a complex mission critical network is essentials
• Proficiency with TCP/IP, Ethernet switching, routing, firewalls, VPN's, imaging technologies (Ghost), RAID technology, etc.
• Strong network and system documentation skills and ability to utilize Microsoft Visio
• Have experience and willingness to share 24x7 support with other members of the team
• Must thrive in a fast-paced environment with high-rates of change

Preferred Skills:

• F5 Big-IP / Web Server Load Balancing
• CheckPoint Firewall
• Shavlik Hotfix-Checker
• Symantec Ghost
• Dell Server Hardware
• Serena TeamTrack / PVCS Tracker
• ORION Network Monitor (Solar Winds)
• System Management Server (SMS)
• Microsoft Operations Manager (MOM)
• SQL Server and SQL Server Clustering
• Storage Area Networks
• Tape Libraries
• Veritas Backup Exec and/or Net Backup

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Sr. Software Engineer- Irvine, CA

Responsibilities:

• Architecting, designing, developing and maintaining enterprise grade software, including integration solutions.
• Participating in the design and development of database schemas, data access layers and stored procedures.
• Communicating with Product Management to understand business requirements and translate into technical specifications.

Essential Duties/Software Development:

• Designs, develops, tests and delivers enterprise grade B2B EDI solutions in the workers compensation, bill review, bill repricing and claims processing industry. Implements data exchange solutions using EDI, ANSI standards, Web services, XML, etc.
• Uses SSIS, Pervasive, C# and various .NET/SQL Server tools on Windows platform.
• Participates in the design, development and maintenance of data access software layer and stored procedures.
• Participates in the design of our database models (SQL server).
• Assists in the troubleshooting and resolution of issues escalated from Technical Services.
• Collaborates closely with the Product Management team to specify solutions that meet the business requirements.
• Documents technical specifications, software design and release notes. Adhere to development standards, software development lifecycle processes and SAS 70 audit requirements.
• Ensure technical documentation is created (as part of all assignments) and maintained as the basis for future enhancement and knowledge sharing. Develops reusable unit/integration testing tools in order to minimize defects delivered to the Quality Assurance environment.

General Responsibilities:

• Participates in planning activities by precisely estimating development efforts for defined requirements.
• Meets commitments by delivering accurate, scalable solutions with agreed to milestones.
• Provides the highest level of customer service to customers, whether these are current or prospective clients of the Company, vendors, staff, business partners or visitors.
• Assists and cooperates with co-workers, supervisor and management.
• Manages confidential client, financial and employee information with discretion and good judgment in accordance with department and Company guidelines.
• Demonstrates a dependable work ethic.
• Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; benchmarking state-of-the art practices; participating in professional societies.
• Ensure tasks performed are consistent with established company priorities.

Qualifications/Software Development:

• 6+ years of software development experience in C# and ASP.NET
• 4+ years experience implementing B2B integration or EAI solutions using XML and Web Services. Strong understanding of SOA concepts.
• Strong remoting experience required. WCF experience a strong plus.
• Strong OO software design and architecture skills required. UML – a plus.
• Knowledge of SQL Server 2000 or SQL Server 2005, including:
  • Database design and implementation
  • Stored procedure design and development
  • SSIS package development – a plus
• Strong knowledge of the software development lifecycle. Familiarity with Agile methodologies (RUP, SCRUM, XP, MSF) – a plus.
• Experience in working collaboratively with 3 rd party to develop interface specification documentation for use in building B2B integration – a strong plus.
• Experience with Pervasive, BizTalk, WebMethods, Tibco or other leading EAI tools – a plus.

Qualifications/General:

• College degree in computer science, engineering or equivalent required.
• The ability to effectively and efficiently manage and prioritize work, with the ability to handle multiple activities with changing priorities simultaneously.
• Effective oral, written and presentation skills and the ability to develop long-term business relationships.
• Demonstrated ability to resolve issues independently and to problem-solve complex technical issues.
• Ability to function as a team player and to be a self starter.
• Ability to grasp complex requirements and specifications, then break them down for the purpose of implementation.
• Ability to determine how changes impact customers and other systems.
• Competency to utilize Company software, proficiency in Microsoft software applications and a willingness to learn new systems as necessary.

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Sr. EDI Database Developer - Irvine, CA

Responsibilities:

• Architecting, designing, developing and maintaining B2B solutions and enterprise grade software.
• Participating in the design and development of database schemas, data access layers and stored procedures.
• Communicating with Product Management to understand business requirements and translate into technical specifications.

Essential Duties/Software Development:

• Designs, develops, tests and delivers enterprise grade software in the workers compensation, bill review, bill repricing and claims processing industry.
• Designs, develops, tests and delivers enterprise applications integration solutions.
• Uses C#, ASP.NET, WCF, web services, XML and various.NET tools on Windows platform.
• Takes a leadership role in implementing some next generation architectural changes.
• Participates in the design, development and maintenance of data access software layer and stored procedures. Participates in the design of our database models (SQL server).
• Assists in the troubleshooting and resolution of issues escalated from Technical Services.
• Collaborates closely with the Product Management team to specify solutions that meet the business requirements.
• Documents technical specifications, software design and release notes. Adhere to development standards, software development lifecycle processes and SAS 70 audit requirements.
• Ensure technical documentation is created (as part of all assignments) and maintained as the basis for future enhancement and knowledge sharing.
• Develops reusable unit/integration testing tools in order to minimize defects delivered to the Quality Assurance environment.

General responsibilities:

• Participates in planning activities by precisely estimating development efforts for defined requirements.
• Meets commitments by delivering accurate, scalable solutions with agreed to milestones.
• Provides the highest level of customer service to customers, whether these are current or prospective clients of the Company, vendors, staff, business partners or visitors.
• Assists and cooperates with co-workers, supervisor and management.
• Manages confidential client, financial and employee information with discretion and good judgment in accordance with department and Company guidelines.
• Demonstrates a dependable work ethic.
• Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; benchmarking state-of-the art practices; participating in professional societies.

Qualifications/Software Development:

• 5+ years experience developing EDI, data transformation and mapping solutions with SQL Server 2000 or SQL Server 2005, including:
  • Strong SQL skills
  • SSIS packages development
  • Database design and implementation
  • Stored procedure design and development
  • Data mapping between database schemas and EDI files
• Experience in working collaboratively with 3rd party to develop interface specification documentation for use in building B2B integration.
• Experience with .Net framework, C# and ADO.Net.
• Knowledge of XML, Web Services and SOA concepts.
• Experience developing B2B solutions utilizing Healthcare ANSI standards such as ANSI X12N 837 Standard – a strong plus.
• Experience with Pervasive, Cognos, Business Objects, BizTalk, WebMethods, Tibco or other leading ETL/EAI tools – a plus.
• Knowledge of the software development life cycle (Agile, RUP, MSF), OO design and/or UML – a plus.
• Knowledge of data warehousing concepts and OLAP – a plus.

Qualifications/General:

• College degree in computer science, engineering or equivalent required.
• The ability to effectively and efficiently manage and prioritize work, with the ability to handle multiple activities with changing priorities simultaneously.
• Effective oral, written and presentation skills and the ability to develop long-term business relationships.
• Demonstrated ability to resolve issues independently and to problem-solve complex technical issues.
• Ability to function as a team player and to be a self starter.
• Ability to grasp complex requirements and specifications, then break them down for the purpose of implementation.
• Ability to determine how changes impact customers and other systems.
• Competency to utilize Company software, proficiency in Microsoft software applications and a willingness to learn new systems as necessary.

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Bill Review Operations Team Lead - Irvine, CA

Duties/Responsibilities:

• Distributes work assignments to team members on a daily basis.
• Performs bill review responsibilities assisting with increased work volume or backlogs due to staff shortages.
• Cooperates with other team leads to achieve a balanced workload within the Operations department.
• Gathers team productivity and quality statistics and completes daily performance tracking logs on a daily basis.
• Reviews and audits work produced by the team; identifies and holds bills that require supervisor intervention.
• Performs routine analysis of production reports to ensure quality, quantity and turnaround time targets are achieved.
• Establishes effective working relationships with Client Services Department to ensure Service Level Agreements with clients are met or exceeded.

Qualifications:

• Four or more years experience in the workers’ compensation industry, preferably in medical bill review.
• Working knowledge of Workers’ Compensation medical fee schedules, state compliance regulations, Medicare guidelines, ICD-9, CPT, RVS and other healthcare programs.
• Good verbal, written and interpersonal skills.
• Effective oral, written and communication skills.
• Good organizational skills and time management skills.
• Competency to utilize Company software and proficiency in Microsoft software applications and a willingness to learn new systems as necessary.
• Ability to work overtime as needed.
• Strong team player with the ability to drive results independently and take initiative.
• Strong analytical thinking and end-to-end problem solving skills.
  

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Hospital Specialist - Irvine, CA

Duties/Responsibilities:

• Enters information into StrataCare system to make coding determination
• Reviews Explanation of Review for accuracy and compliance with State mandated fee schedules and StrataCare business rules and practices
• Researches and analyzes PPO Contracts and Medicare guidelines to apply appropriate discounts to medical claims
• Refers to reference library of fee schedules, CPT, ICD-9, HCPCS and other industry publications to support findings
• Contacts providers directly to obtain missing information or documentation
• Collaborates with Medical Bill Services (MBS) to obtain negotiated discounts on medical claims

Qualifications:

• Three or more years experience in the workers’ compensation industry, preferably in medical bill review
• Extensive working knowledge of Workers’ Compensation fee schedules, compliance regulations, Medicare guidelines, ICD-9, RVS/CPT, and other healthcare programs Strong analytical and problem solving skills
• Ability to read, analyze and interpret contracts and governmental regulations
• Working knowledge of anatomy, surgery and medical terminology
• Good organizational skills
• Competency to utilize Company software and proficiency in Microsoft software applications and a willingness to learn new systems as necessary
• Ability to work overtime as needed
  

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