Lucent Health jobs - 22 jobs

About Lucent Health Lucent Health combines top-tier claims management with a compassionate, human-focused, data-driven care management solution. This approach helps self-insured employers provide care management that enables health plan participants to make smarter, cost-saving healthcare decisions. Continuous data analytics offer ongoing insights, ensuring participants receive the right care, at the right cost, at the right time. Join us as we build a company that aims to be a better health benefits partner for self-insured employers. Company Culture We believe that the success of Lucent Health relies on having employees who are honest, ethical and hardworking. These values are the foundation of Lucent Health. Honest Transparent Communication: be open and clear in all interactions without withholding crucial information Integrity: ensure accuracy in reporting, work outputs and any tasks assigned Truthfulness: provide honest feedback and report any issues or challenges as they arise Trustworthiness: build and maintain trust by consistently demonstrating reliable behavior Ethical Fair Decision Making: ensure all actions and decisions respect company policies and values Accountability: own up to mistakes and take responsibility for rectifying them Respect: treat colleagues, clients and partners with fairness and dignity Confidentiality: safeguard sensitive information and avoid conflicts of interest Hardworking Consistency: meet or exceed deadlines, maintaining high productivity levels Proactiveness: take initiative to tackle challenges without waiting to be asked Willingness: voluntarily offer to assist in additional projects or tasks when needed Adaptability: work efficiently under pressure or in changing environments Summary A Salesforce Administrator is responsible for managing and optimizing the Salesforce platform to meet business needs, ensuring effective utilization of the CRM system, and providing support and training to users. Responsibilities User Management: Manage user accounts, profiles, roles, and permissions to ensure secure access to Salesforce data. System Configuration: Customize Salesforce to fit the organization's needs, including creating and managing fields, views, reports, dashboards, and workflows. Data Management: Perform database maintenance tasks, including data cleansing, duplicate management, and ensuring data integrity. Training and Support: Provide training and support to end-users, helping them effectively utilize Salesforce tools and features. Collaboration: Work closely with stakeholders to gather requirements and translate them into system solutions that enhance business processes. System Upgrades: Evaluate, install, and manage Salesforce updates and add-ons to keep the system current and efficient. Reporting and Analytics: Develop customized reports and dashboards to monitor data quality and business performance metrics. Qualifications Experience: Proven experience in Salesforce administration, with a solid understanding of business operations and analytical capabilities. Certifications: Salesforce Administrator certification is often preferred or required. Technical Skills: Strong technical knowledge of Salesforce software, including its functionalities and best practices for configuration and management. Problem-Solving Skills: Ability to troubleshoot and resolve technical issues that may arise within the Salesforce platform. Communication Skills: Excellent interpersonal skills to liaise with various stakeholders and effectively communicate technical concepts to non-technical users. Equal Employment Opportunity Policy Statement Lucent Health is an Equal Opportunity Employer that does not discriminate based on actual or perceived race, color, creed, religion, alienage or national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth and related medical conditions), gender identity, gender expression, transgender status, sexual orientation, marital status, military service and veteran status.

About Lucent Health Lucent Health combines top-tier claims management with a compassionate, human-focused, data-driven care management solution. This approach helps self-insured employers provide care management that enables health plan participants to make smarter, cost-saving healthcare decisions. Continuous data analytics offer ongoing insights, ensuring participants receive the right care, at the right cost, at the right time. Join us as we build a company that aims to be a better health benefits partner for self-insured employers. Company Culture We believe that the success of Lucent Health relies on having employees who are honest, ethical and hardworking. These values are the foundation of Lucent Health. Honest Transparent Communication: be open and clear in all interactions without withholding crucial information Integrity: ensure accuracy in reporting, work outputs and any tasks assigned Truthfulness: provide honest feedback and report any issues or challenges as they arise Trustworthiness: build and maintain trust by consistently demonstrating reliable behavior Ethical Fair Decision Making: ensure all actions and decisions respect company policies and values Accountability: own up to mistakes and take responsibility for rectifying them Respect: treat colleagues, clients and partners with fairness and dignity Confidentiality: safeguard sensitive information and avoid conflicts of interest Hardworking Consistency: meet or exceed deadlines, maintaining high productivity levels Proactiveness: take initiative to tackle challenges without waiting to be asked Willingness: voluntarily offer to assist in additional projects or tasks when needed Adaptability: work efficiently under pressure or in changing environments Summary The Project Data Entry Specialist is responsible for organizing, tracking, and processing key financial and operational data related to vendor invoicing, percentage-of-savings fees, and special handling or IDR claims. This role ensures that all entries are accurate, timely, and compliant with internal controls-supporting the TPA's ability to administer self-funded medical health plans efficiently and maintain strong vendor and client relationships. Responsibilities Accurately enter, track, and process vendor invoices, percentage-of-savings fee claims, and IDR (Independent Dispute Resolution) fee claims in accordance with established procedures and timelines. Review and reconcile claim and invoice data to ensure accuracy, completeness, and alignment with network contracts or client specifications. Maintain detailed logs and databases to track the status of invoices and claims requiring special handling or project-based processing. Collaborate with the Finance, Claims, and Vendor Management teams to resolve discrepancies or obtain clarification on billing details. Ensure documentation and data entry meet audit standards and organizational requirements for accuracy and record retention. Assist with preparing reports and summaries of vendor and fee claim activity for management review and performance tracking. Monitor workflow to ensure timely completion of all assigned entries and projects, escalating any delays or issues to leadership promptly. Contribute to process improvement initiatives by identifying opportunities to streamline data entry, tracking, or reconciliation practices. Qualifications High school diploma or equivalent required; associate's degree preferred. 2+ years of data entry, billing, or claims-related experience in a healthcare or TPA environment preferred. Strong attention to detail with exceptional organizational and time management skills. Proficiency in Microsoft Excel and other data management systems. Ability to maintain accuracy and productivity in a deadline-driven environment. Excellent communication and teamwork skills with a commitment to accuracy and confidentiality. Equal Employment Opportunity Policy Statement Lucent Health is an Equal Opportunity Employer that does not discriminate based on actual or perceived race, color, creed, religion, alienage or national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth and related medical conditions), gender identity, gender expression, transgender status, sexual orientation, marital status, military service and veteran status.

About Lucent Health Lucent Health combines top-tier claims management with a compassionate, human-focused, data-driven care management solution. This approach helps self-insured employers provide care management that enables health plan participants to make smarter, cost-saving healthcare decisions. Continuous data analytics offer ongoing insights, ensuring participants receive the right care, at the right cost, at the right time. Join us as we build a company that aims to be a better health benefits partner for self-insured employers. Company Culture We believe that the success of Lucent Health relies on having employees who are honest, ethical and hardworking. These values are the foundation of Lucent Health. Honest Transparent Communication: be open and clear in all interactions without withholding crucial information Integrity: ensure accuracy in reporting, work outputs and any tasks assigned Truthfulness: provide honest feedback and report any issues or challenges as they arise Trustworthiness: build and maintain trust by consistently demonstrating reliable behavior Ethical Fair Decision Making: ensure all actions and decisions respect company policies and values Accountability: own up to mistakes and take responsibility for rectifying them Respect: treat colleagues, clients and partners with fairness and dignity Confidentiality: safeguard sensitive information and avoid conflicts of interest Hardworking Consistency: meet or exceed deadlines, maintaining high productivity levels Proactiveness: take initiative to tackle challenges without waiting to be asked Willingness: voluntarily offer to assist in additional projects or tasks when needed Adaptability: work efficiently under pressure or in changing environments Summary : The Manager- Check Run oversees and manages the end-to-end process of generating, reviewing, approving, and distributing claim payment checks and electronic funds transfers (EFTs) for a health insurance organization. This role ensures accuracy, compliance with regulatory requirements, timeliness of payments, and coordination across finance, claims, and IT teams. They are responsible for safeguarding the integrity of payment processes, maintaining proper audit documentation, and ensuring that payments are issued according to plan sponsor agreements and company policies. Responsibilities: Plan, schedule, and execute weekly, bi-weekly, and ad-hoc check runs for provider, member, and vendor claim payments. Review and reconcile payment batches to ensure accuracy of amounts, payee information, and claim data. Coordinate with claims operations to resolve any discrepancies prior to payment release. Oversee the generation of both physical checks and EFT/ACH transactions. Ensure all check runs comply with federal, state, and plan-specific payment regulations. Maintain detailed documentation for internal controls and external audits (e.g., HIPAA, SOC, NAIC). Manage positive pay files and coordinate with banking partners to prevent fraud. Serve as the primary liaison between Claims, Finance, IT, and banking partners for payment processes. Communicate payment schedules and any delays to internal stakeholders. Support vendor and provider inquiries related to payment status or issues. Develop and maintain standard operating procedures (SOPs) for check run and payment processes. Identify opportunities to streamline workflows and improve payment accuracy and timeliness. Implement automation or system enhancements in coordination with IT and software vendors. Oversee payment processing staff (if applicable), providing training, guidance, and performance feedback. Qualifications: Bachelor's degree in Finance, Accounting, Business Administration, or related field; or equivalent work experience. 3-5 years of experience in payment processing, accounts payable, or claims finance operations in a health insurance or healthcare environment. Strong understanding of healthcare claims payment cycles, EOB/EOP generation, and provider/member payment regulations. Familiarity with HIPAA and other healthcare compliance requirements. Proficiency with claims administration systems and accounting software (e.g., Facets, QNXT, Javelina, Great Plains, etc.). Strong attention to detail and accuracy. Excellent communication and organizational skills. Preferred Qualifications: Supervisory experience. Experience with positive pay processes and fraud prevention tools. Knowledge of electronic payment file formats (ACH, 835/ERA, 837). Equal Employment Opportunity Policy Statement Lucent Health is an Equal Opportunity Employer that does not discriminate based on actual or perceived race, color, creed, religion, alienage or national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth and related medical conditions), gender identity, gender expression, transgender status, sexual orientation, marital status, military service and veteran status.

About Lucent Health Lucent Health combines top-tier claims management with a compassionate, human-focused, data-driven care management solution. This approach helps self-insured employers provide care management that enables health plan participants to make smarter, cost-saving healthcare decisions. Continuous data analytics offer ongoing insights, ensuring participants receive the right care, at the right cost, at the right time. Join us as we build a company that aims to be a better health benefits partner for self-insured employers. Company Culture We believe that the success of Lucent Health relies on having employees who are honest, ethical and hardworking. These values are the foundation of Lucent Health. Honest Transparent Communication: be open and clear in all interactions without withholding crucial information Integrity: ensure accuracy in reporting, work outputs and any tasks assigned Truthfulness: provide honest feedback and report any issues or challenges as they arise Trustworthiness: build and maintain trust by consistently demonstrating reliable behavior Ethical Fair Decision Making: ensure all actions and decisions respect company policies and values Accountability: own up to mistakes and take responsibility for rectifying them Respect: treat colleagues, clients and partners with fairness and dignity Confidentiality: safeguard sensitive information and avoid conflicts of interest Hardworking Consistency: meet or exceed deadlines, maintaining high productivity levels Proactiveness: take initiative to tackle challenges without waiting to be asked Willingness: voluntarily offer to assist in additional projects or tasks when needed Adaptability: work efficiently under pressure or in changing environments Summary : The Account Executive is the main point of contact with the client and works directly with the broker and clients to understand the customer culture and business objectives as it relates to their benefit plan design. They will provide consultative services to ensure the positive movement toward meeting their benefit plan objectives. The Account Executive identifies marketplace opportunities, prospects and engages new clients, develops proposals for renewals, manages the renewal and contract process that leads to a successful implementation of client groups, works to retain an assigned book of business and, look for opportunities for growth within assigned accounts. Responsibilities: include the following. Other duties may be assigned. Fulfills ongoing service needs for Book of Business to be assigned. Coordinates expirations with Producer to obtain renewal and/or new business information. Markets new and renewal business; prepares analyses of alternative benefits proposals; prepares marketing materials and client presentations. Maintains underwriting and marketing information by carrier. Understands products and determines the opportunity for new product integration. Processes renewal or new business enrollment paperwork. Follows-up during process with client and carriers. Schedules and performs Quarterly in-person meetings with the Brokers and Clients throughout the year. Work with brokers and consultants to analyze benefit plan experience, data and industry trends. Serves as a facilitator with regards to calls and/or correspondence from clients and companies regarding insurance, claims, and/or administrative problems, with a goal of successful and efficient problem resolution. Participates in and/or leads annual Enrollment/Benefits meetings for client employees. Stays abreast of ongoing industry practices, trends and regulations through participation in departmental meetings and educational events as well as through continuous attention to industry briefs, updates and legislative news. Regular, predictable attendance is required. Ability to get along and work effectively with others. Travel This position may occasionally require up to 30% travel in support of Outside Sales Executive and client engagement. Travel may be in or outside the local area and could sometimes require overnight. Qualifications At least five years of sales experience at the Account Manager, or Account Executive level. Bachelor's degree or equivalent experience. Five plus years of sales experience in a healthcare insurance organization. Valid Producer License Preferred Education and Experience Advanced training in industry related sales techniques. Life Agent License. Equal Employment Opportunity Policy Statement Lucent Health is an Equal Opportunity Employer that does not discriminate based on actual or perceived race, color, creed, religion, alienage or national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth and related medical conditions), gender identity, gender expression, transgender status, sexual orientation, marital status, military service and veteran status.

About Lucent Health Lucent Health combines top-tier claims management with a compassionate, human-focused, data-driven care management solution. This approach helps self-insured employers provide care management that enables health plan participants to make smarter, cost-saving healthcare decisions. Continuous data analytics offer ongoing insights, ensuring participants receive the right care, at the right cost, at the right time. Join us as we build a company that aims to be a better health benefits partner for self-insured employers. Company Culture We believe that the success of Lucent Health relies on having employees who are honest, ethical and hardworking. These values are the foundation of Lucent Health. Honest Transparent Communication: be open and clear in all interactions without withholding crucial information Integrity: ensure accuracy in reporting, work outputs and any tasks assigned Truthfulness: provide honest feedback and report any issues or challenges as they arise Trustworthiness: build and maintain trust by consistently demonstrating reliable behavior Ethical Fair Decision Making: ensure all actions and decisions respect company policies and values Accountability: own up to mistakes and take responsibility for rectifying them Respect: treat colleagues, clients and partners with fairness and dignity Confidentiality: safeguard sensitive information and avoid conflicts of interest Hardworking Consistency: meet or exceed deadlines, maintaining high productivity levels Proactiveness: take initiative to tackle challenges without waiting to be asked Willingness: voluntarily offer to assist in additional projects or tasks when needed Adaptability: work efficiently under pressure or in changing environments Summary The Stop Loss Analyst plays a pivotal role in managing financial risk associated with self-funded health plans. This position supports the underwriting and claims processes by evaluating large claims, tracking stop loss reimbursement trends, and ensuring accurate and timely submissions. Ideal candidates will combine analytical rigor with industry knowledge to protect the TPA and its clients from catastrophic claims exposure. Responsibilities Evaluate large medical and pharmacy claims for stop loss reimbursement eligibility Assist in preparation and submission of stop loss claims to carriers, ensuring compliance with contract terms Monitor reimbursements and maintain status updates on pending claims Collaborate with internal departments (Claims, Care Management, Finance) to gather documentation Liaise with stop loss carriers to resolve claim issues and provide necessary support Maintain detailed records in accordance with regulatory and HIPAA standards Identify process inefficiencies and recommend improvements to optimize claims cycle time Qualifications Bachelor's degree in Business, Finance, Health Administration, or related field (preferred) 2+ years of experience in stop loss claims or TPA operations Strong working knowledge of self-funded health plans and stop loss contracts Advanced Excel skills; proficiency in data analytics tools a plus Exceptional attention to detail and organizational skills Excellent communication and relationship management abilities Preferred Qualifications Familiarity with ICD-10, CPT, and medical coding terminology Familiarity with LuminX or QicLink platforms Ability to interpret legal and contractual language Experience with claim adjudication systems or benefit platforms Independent and proactive problem-solving mindset Equal Employment Opportunity Policy Statement Lucent Health is an Equal Opportunity Employer that does not discriminate based on actual or perceived race, color, creed, religion, alienage or national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth and related medical conditions), gender identity, gender expression, transgender status, sexual orientation, marital status, military service and veteran status.

About Lucent Health Lucent Health combines top-tier claims management with a compassionate, human-focused, data-driven care management solution. This approach helps self-insured employers provide care management that enables health plan participants to make smarter, cost-saving healthcare decisions. Continuous data analytics offer ongoing insights, ensuring participants receive the right care, at the right cost, at the right time. Join us as we build a company that aims to be a better health benefits partner for self-insured employers. Company Culture We believe that the success of Lucent Health relies on having employees who are honest, ethical and hardworking. These values are the foundation of Lucent Health. Honest Transparent Communication: be open and clear in all interactions without withholding crucial information Integrity: ensure accuracy in reporting, work outputs and any tasks assigned Truthfulness: provide honest feedback and report any issues or challenges as they arise Trustworthiness: build and maintain trust by consistently demonstrating reliable behavior Ethical Fair Decision Making: ensure all actions and decisions respect company policies and values Accountability: own up to mistakes and take responsibility for rectifying them Respect: treat colleagues, clients and partners with fairness and dignity Confidentiality: safeguard sensitive information and avoid conflicts of interest Hardworking Consistency: meet or exceed deadlines, maintaining high productivity levels Proactiveness: take initiative to tackle challenges without waiting to be asked Willingness: voluntarily offer to assist in additional projects or tasks when needed Adaptability: work efficiently under pressure or in changing environments Summary The maternity case manager shall work in a collaborative means to promote quality care and cost- effective outcomes that will enhance the physical, psychosocial, and vocational health of the plan participants. The case manager shall work within the policies and procedures of Lucent Health and according to the Practice Guidelines accepted by the profession of case management. Responsibilities Performs all phases of the case management process which shall include: Assessment Defines role and scope of activities to the patient in a comprehensible manner. Communicates to the patient that the information gathered will be shared with the payer. Gathers consent for case management activities. Determines individual needs based on an assessment that identifies all significant needs related to the Medical condition and care (current diagnosis - primary and secondary, treatment plan and prognosis, projected length of treatment/anticipated cost, physicians - primary and specialists, significant history - patient and family, response to previous treatment, potential problems and complications, patient understanding of diagnosis and prognosis, experimental/controversial treatment, anticipated location of care, medications, need for equipment/supplies/etc., need for ancillary services), the Psychosocial condition and care (language, cultural influences, support systems and significant others, financial status, coping behaviors, compliance issues, living arrangements, home environment, religious beliefs, advance directives, patient goals/plans/wishes, teaching needs, transportation issues, ability to perform self-care), the Vocational situation (current vocational status, training/education, desire to return to work, job description, transferable skills, general interests/talents, wage earning abilities), the Payer issues (benefit plan design, PPO'S, policy limits/exclusions, eligibility for additional resources, ability to go outside of policy limits, laws affecting coverage, payer contact), available community resources, and barriers to effective outcomes. Works in a holistic manner, considering both medical and psychosocial issues. Identifies issues that might interfere with the provision of the highest quality, most appropriate, cost-effective care. Keeps in mind that a thorough, objective assessment is necessary to a successful outcome. Planning and Coordination: Creates an individualized plan of action based on the assessment which facilitates the coordination of appropriate and necessary treatment and services required by the patient. Gives consideration, in developing the plan, to the benefit plan design/coverage options. Sets appropriate, measurable goals. Provides the patient with information to make "informed" decisions, empowering and encouraging the patient to make his own decisions through including him in the planning process. Develops contingency plans Facilitates communication of the patient's wishes to all members of the health care team. When appropriate, discusses advanced directives. Obtains the acceptance of all parties (patient, family, payer, and providers) prior to instituting the plan. Develops a plan which advocates for the patient and maximizes benefit dollars. Researches and includes costs of services and use of community resources in plan design. Implementation and Monitoring: Implements a plan that is based on the assessment. Skillfully negotiates and coordinates care based on the plan developed. Identifies and coordinates resources to ensure success of the plan. Works within the plan network as possible. Refers to only those providers that are familiar or researched to ensure high quality (either through personal knowledge/experience, onsite inspections, conversations with providers, review of accreditations and credentials, networking with other case managers, review of outcomes, statistics, payer, and patient satisfaction). Monitors the provision of the coordinated plan. Reviews the care plan for compliance with standards of care and coordinates physician review when needed of procedures, medications, and care plans to ensure that services are medically necessary and consistent with care standards and health plan language. Appropriately communicates the outcome of medical necessity reviews per policy. Evaluation Evaluates plan on a regular basis to determine effectiveness, patient satisfaction, provider comfort, payer satisfaction, if the plan is meeting the needs of all involved parties (but most particularly-the patient's needs) cost effectiveness, patient compliance with treatment, and the impact on the patient's quality of life. Determines if revisions are required due to changes in medical condition, family status, insurance coverage, etc. Maintains availability and willingness to revise the plan as needed. Continues involvement as active, effective case manager. Maintains well-organized, objective, factual, clear, and concise documentation that reflects what was done on the cases and why it was done, adhering to policies regarding timeliness. Documentation of the plan must include who, what, where, when why and costs. Teaching of the patient and family is documented. Performs as a patient advocate, in an ethical manner at all times, incorporating case management concepts and following industry standards and guidelines. Becomes involved in the case management process as early as possible following the onset or diagnosis and maintains involvement throughout the course of the illness or injury (not just episodically), managing a case along the entire spectrum of care (home care, acute care hospital, subacute, rehabilitation, etc.), coordinating cost effective plans that provide quality and continuity of care while eliminating duplication of services and wasted benefit dollars. Demonstrates effective communication skills, both written and verbal, with all members of the treatment (physicians, providers, patients, families, significant others), employer, and payer team. Adheres to the Quality Assurance standards of the unit at a minimum of 85% of the time. Qualifications: 1. Active, unrestricted RN license in the state(s) of practice - Multi State license required. 2. Current certified case manager (CCM) credential preferred. 3. A minimum of three (3) years of clinical experience in maternity telephonic case management, facility case management or nurse navigator experience. Preferred clinical experience in bedside maternity nursing environment. 4. Ability to multi-task including navigation of multiple systems, multiple monitors, and have a conversation via telephone simultaneously. 5. Excellent time management and organizational skills, with the ability to maintain flexibility and work independently. Equal Employment Opportunity Policy Statement Lucent Health is an Equal Opportunity Employer that does not discriminate based on actual or perceived race, color, creed, religion, alienage or national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth and related medical conditions), gender identity, gender expression, transgender status, sexual orientation, marital status, military service and veteran status.

About Lucent Health Lucent Health combines top-tier claims management with a compassionate, human-focused, data-driven care management solution. This approach helps self-insured employers provide care management that enables health plan participants to make smarter, cost-saving healthcare decisions. Continuous data analytics offer ongoing insights, ensuring participants receive the right care, at the right cost, at the right time. Join us as we build a company that aims to be a better health benefits partner for self-insured employers. Company Culture We believe that the success of Lucent Health relies on having employees who are honest, ethical and hardworking. These values are the foundation of Lucent Health. Honest Transparent Communication: be open and clear in all interactions without withholding crucial information Integrity: ensure accuracy in reporting, work outputs and any tasks assigned Truthfulness: provide honest feedback and report any issues or challenges as they arise Trustworthiness: build and maintain trust by consistently demonstrating reliable behavior Ethical Fair Decision Making: ensure all actions and decisions respect company policies and values Accountability: own up to mistakes and take responsibility for rectifying them Respect: treat colleagues, clients and partners with fairness and dignity Confidentiality: safeguard sensitive information and avoid conflicts of interest Hardworking Consistency: meet or exceed deadlines, maintaining high productivity levels Proactiveness: take initiative to tackle challenges without waiting to be asked Willingness: voluntarily offer to assist in additional projects or tasks when needed Adaptability: work efficiently under pressure or in changing environments Summary The Implementation Specialist initiates and assists with both implementing and renewing Lucent Health clients. This role serves as a visible contact for new clients, setting the tone of ongoing relationships, while also facilitating renewal changes to satisfy and retain clients. The Implementation Specialist completes assigned tasks efficiently and accurately to deliver a satisfactory implementation experience for internal teams and valued customers. Responsibilities: Collect intake forms and documentation to initiate implementations. Review and comprehend existing client benefits to populate Lucent systems for implementation. Complete tasks accurately and track completion in relevant systems. Commit to understanding Lucent's business to gain full knowledge of the implementation process and understand related operational, IT, and compliance processes. Coordinate and lead meetings with brokers, clients, and internal teams as appropriate. Think critically to anticipate and navigate obstacles and improve processes. Expectations: Learn and maintain up-to-date and thorough knowledge of self-funded group health benefits including Reference Based Pricing, Traditional Medical, Care Coordination and Management, Prescription Drug, MEC, Dental, Flex, and Vision plans. Demonstrate excellent communication, troubleshooting, listening, and problem-solving skills. Embrace a sense of urgency to meet critical timelines based on each client's desired open enrollment and effective date. Participate in implementation team building and quality improvement initiatives to work transparently and collaboratively. Demonstrate excellent organization skills by learning and using implementation systems and processes adeptly. Qualifications Minimum 1+ year project management, coaching, or comparable skill. TPA workflow knowledge. Medical/health care experience preferred. Developed computer skills including data manipulation and comprehension. Sales support/Client Services/Account Management experience. Project Management or comparable organization skills. Excellent written and verbal communication skills. Attention to detail. Customer-service focus. Problem solving/analysis. Adept tech skills in SalesForce, Smartsheet (PM tools), Microsoft Office Bachelor- or Associate-level degree preferred. Equal Employment Opportunity Policy Statement Lucent Health is an Equal Opportunity Employer that does not discriminate based on actual or perceived race, color, creed, religion, alienage or national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth and related medical conditions), gender identity, gender expression, transgender status, sexual orientation, marital status, military service and veteran status.

About Lucent Health Lucent Health combines top-tier claims management with a compassionate, human-focused, data-driven care management solution. This approach helps self-insured employers provide care management that enables health plan participants to make smarter, cost-saving healthcare decisions. Continuous data analytics offer ongoing insights, ensuring participants receive the right care, at the right cost, at the right time. Join us as we build a company that aims to be a better health benefits partner for self-insured employers. Company Culture We believe that the success of Lucent Health relies on having employees who are honest, ethical and hardworking. These values are the foundation of Lucent Health. Honest Transparent Communication: be open and clear in all interactions without withholding crucial information Integrity: ensure accuracy in reporting, work outputs and any tasks assigned Truthfulness: provide honest feedback and report any issues or challenges as they arise Trustworthiness: build and maintain trust by consistently demonstrating reliable behavior Ethical Fair Decision Making: ensure all actions and decisions respect company policies and values Accountability: own up to mistakes and take responsibility for rectifying them Respect: treat colleagues, clients and partners with fairness and dignity Confidentiality: safeguard sensitive information and avoid conflicts of interest Hardworking Consistency: meet or exceed deadlines, maintaining high productivity levels Proactiveness: take initiative to tackle challenges without waiting to be asked Willingness: voluntarily offer to assist in additional projects or tasks when needed Adaptability: work efficiently under pressure or in changing environments Summary: We are looking for a skilled healthcare Check Run Analyst (Payment Posting) for the set-up, maintenance, and completion of our clients' check runs. The ideal person is responsible for the maintenance of the check registers, and the maintenance of the check run guidelines and schedules. The individual must be able to efficiently multi-task and prioritize in performing the responsibilities listed below. Responsibilities: Daily servicing of client requests via email and telephone contacts Receive and interpret data; enter information into the benefits processing system Run daily and monthly reports for our clients, as needed Run daily flex and disability check runs Interface with clients, suppliers, and/or company employees in other departments on a regular basis to give or exchange information Additional duties as assigned Qualifications Bachelor's degree in Business, Finance, Health Administration, or related field (preferred) Insatiable appetite for attention to details, working with numbers, and organization 3 or more years' experience reconciling and balancing financial accounts Successfully manage check-runs and post payments to fund the right client accounts 3 years minimum general accounting experience in an administrative financial role 3 years minimum proficiency in the use of computer databases and applications including the Microsoft Office Suite (e.g., Outlook, Word, and Excel) Good interpersonal skills and passion to interact with others; internally and externally Must be able to perform with a sense of urgency and can prioritize multiple tasks Experience and understanding of Insurance carrier environment, preferred Experience and understanding of Insurance carrier healthcare claims, a plus Administrative Financial Services: 3 years (Preferred) Reconciling and balancing financial accounts: 3 years (Preferred) Payment Processing and Funding: 3 years (Preferred) High school or equivalent (Preferred) Familiarity with ICD-10, CPT, and medical coding terminology Familiarity with LuminX or QicLink platforms Equal Employment Opportunity Policy Statement: Lucent Health Solutions, Inc. is an Equal Opportunity Employer that does not discriminate based on actual or perceived race, creed, color, religion, alienage or national origin, ancestry, citizenship status, age, disability or handicap, sex, marital status, veteran status, sexual orientation, genetic information, gender identity, gender expression, transgender status, arrest record, or any other characteristic protected by applicable federal, state or local laws. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.

About Lucent Health Lucent Health combines top-tier claims management with a compassionate, human-focused, data-driven care management solution. This approach helps self-insured employers provide care management that enables health plan participants to make smarter, cost-saving healthcare decisions. Continuous data analytics offer ongoing insights, ensuring participants receive the right care, at the right cost, at the right time. Join us as we build a company that aims to be a better health benefits partner for self-insured employers. Company Culture We believe that the success of Lucent Health relies on having employees who are honest, ethical and hardworking. These values are the foundation of Lucent Health. Honest Transparent Communication: be open and clear in all interactions without withholding crucial information Integrity: ensure accuracy in reporting, work outputs and any tasks assigned Truthfulness: provide honest feedback and report any issues or challenges as they arise Trustworthiness: build and maintain trust by consistently demonstrating reliable behavior Ethical Fair Decision Making: ensure all actions and decisions respect company policies and values Accountability: own up to mistakes and take responsibility for rectifying them Respect: treat colleagues, clients and partners with fairness and dignity Confidentiality: safeguard sensitive information and avoid conflicts of interest Hardworking Consistency: meet or exceed deadlines, maintaining high productivity levels Proactiveness: take initiative to tackle challenges without waiting to be asked Willingness: voluntarily offer to assist in additional projects or tasks when needed Adaptability: work efficiently under pressure or in changing environments Overview: The Account Manager professional assists the Account Executive Team in managing an assigned book of business and builds, expands, and solidifies relationships with existing clients and Brokers. Account Managers are intrical in identifying benefit plan issues and work as the liaison between the Operations Team and the Client to assure the benefit program is administered as intended. Responsibilities Provides clients with appropriate resources to address member benefit needs and questions by being the main day to day contact for escalated claims, billing and enrollment questions Focuses on retaining existing business with excellent customer service Assists in identifying opportunity to improve client and member experience Provides administrative and customer service support to the main Employer contact/Plan decision makers Supports Senior Account Executive staff with New Business and Renewal implementation tasks Assists in reporting requests: Weekly, Monthly and Quarterly specialty plan analysis reporting Assists with end of contract Stop Loss review Assists with special projects as necessary (Example: Sales RFP requests) Qualifications: Excellent verbal and written communication skill Critical thinking and good judgment to quickly determine and prioritize key issues Must be a team player and be able to work with clients to make all goals, objectives, and time constraints understood Great organizational skills, impeccable attention to detail and the motivation to take projects and processes to the next level Excellent verbal and written communication skill 3+ years' solid experience in healthcare/health information management industry, preferably including third party and/or commercial payer and/or self-funded service experience Account Management experience required in the healthcare industry Client facing experience with exceptional presentation skills is a must Proficiency in all MS Office applications - Advanced knowledge of Excel desired Bachelor's degree desirable Equal Employment Opportunity Policy Statement Lucent Health is an Equal Opportunity Employer that does not discriminate based on actual or perceived race, color, creed, religion, alienage or national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth and related medical conditions), gender identity, gender expression, transgender status, sexual orientation, marital status, military service and veteran status.

About Lucent Health Lucent Health combines top-tier claims management with a compassionate, human-focused, data-driven care management solution. This approach helps self-insured employers provide care management that enables health plan participants to make smarter, cost-saving healthcare decisions. Continuous data analytics offer ongoing insights, ensuring participants receive the right care, at the right cost, at the right time. Join us as we build a company that aims to be a better health benefits partner for self-insured employers. Company Culture We believe that the success of Lucent Health relies on having employees who are honest, ethical and hardworking. These values are the foundation of Lucent Health. Honest Transparent Communication: be open and clear in all interactions without withholding crucial information Integrity: ensure accuracy in reporting, work outputs and any tasks assigned Truthfulness: provide honest feedback and report any issues or challenges as they arise Trustworthiness: build and maintain trust by consistently demonstrating reliable behavior Ethical Fair Decision Making: ensure all actions and decisions respect company policies and values Accountability: own up to mistakes and take responsibility for rectifying them Respect: treat colleagues, clients and partners with fairness and dignity Confidentiality: safeguard sensitive information and avoid conflicts of interest Hardworking Consistency: meet or exceed deadlines, maintaining high productivity levels Proactiveness: take initiative to tackle challenges without waiting to be asked Willingness: voluntarily offer to assist in additional projects or tasks when needed Adaptability: work efficiently under pressure or in changing environments Summary The primary focus of the Implementation Coordinator is to ensure a seamless integration of new groups into the Lucent Operations Process. The crucial component to the Implementation coordinator role is to ensure they are setting a positive tone in the first 90 days of contact with the new group by building a solid rapport in the relationship from day one. Responsibilities : Responsible for tracking the implementation checklist to ensure timely completion of all tasks. Provides daily direction and communication to the operations staff regarding tasks requiring completion for the implementation of new groups. Ensures with the Sales Executive that New Client Questionnaire has been satisfactorily completed by the group and communicated to the operations center. Ensures Plan Building department has completed the Benefits Plan Questionnaire and the Benefits Spreadsheet, and that these documents are understood by the group. Responsible for scheduling and driving implementation calls with the group to include creation of call agenda, recap of previous calls, follow up on outstanding issues, summary from relevant parties on call, wrap up, distribution of notes and tasks. Manage tasks required internally, by brokers, vendors, and the group during the implementation process. Ensure follow up tasks are completed on any outstanding items from weekly implementation calls. Inform group of any information requests and ensure that the info is provided in a timely manner. If the information is not provided explain to the group potential implementation delays. Ensure the timely completion of any documents or contracts provided to the group. Work with corporate Implementation Support staff to ensure Vendor Notifications, Plan Documents, Summary Benefit Cards, and ID cards are completed accurately and on time. Communicate any issues or potential issues to the Account Management Team as the arise. Complete comprehensive handoff with Account Manager at completion of Implementation utilizing the Implementation Completion Checklist. Escalate to management any issues that will delay implementation or processing of claims. Qualifications: Maintain up to date and thorough knowledge of employee benefit provisions for group health plans including VBP, MEC, MERP, Traditional Medical, Dental, Vision and Prescription Drugs, etc. Demonstrate excellent communication, troubleshooting, listening and problem-solving skills Ability to multitask and prioritize, excellent organization skills. Give direction to team members to ensure that all implementation tasks are completed accurately and on time. Coordinate weekly implementation calls to track the progress of each implementation. Minimum 3 years project management. Medical/Health Care experience. Strong computer skills and verbal communication. Account Management experience highly desirable. Equal Employment Opportunity Policy Statement Lucent Health is an Equal Opportunity Employer that does not discriminate based on actual or perceived race, color, creed, religion, alienage or national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth and related medical conditions), gender identity, gender expression, transgender status, sexual orientation, marital status, military service and veteran status.

About Lucent Health Lucent Health combines top-tier claims management with a compassionate, human-focused, data-driven care management solution. This approach helps self-insured employers provide care management that enables health plan participants to make smarter, cost-saving healthcare decisions. Continuous data analytics offer ongoing insights, ensuring participants receive the right care, at the right cost, at the right time. Join us as we build a company that aims to be a better health benefits partner for self-insured employers. Company Culture We believe that the success of Lucent Health relies on having employees who are honest, ethical and hardworking. These values are the foundation of Lucent Health. Honest Transparent Communication: be open and clear in all interactions without withholding crucial information Integrity: ensure accuracy in reporting, work outputs and any tasks assigned Truthfulness: provide honest feedback and report any issues or challenges as they arise Trustworthiness: build and maintain trust by consistently demonstrating reliable behavior Ethical Fair Decision Making: ensure all actions and decisions respect company policies and values Accountability: own up to mistakes and take responsibility for rectifying them Respect: treat colleagues, clients and partners with fairness and dignity Confidentiality: safeguard sensitive information and avoid conflicts of interest Hardworking Consistency: meet or exceed deadlines, maintaining high productivity levels Proactiveness: take initiative to tackle challenges without waiting to be asked Willingness: voluntarily offer to assist in additional projects or tasks when needed Adaptability: work efficiently under pressure or in changing environments Summary The Stop Loss Analyst plays a pivotal role in managing financial risk associated with self-funded health plans. This position supports the underwriting and claims processes by evaluating large claims, tracking stop loss reimbursement trends, and ensuring accurate and timely submissions. Ideal candidates will combine analytical rigor with industry knowledge to protect the TPA and its clients from catastrophic claims exposure. Responsibilities Evaluate large medical and pharmacy claims for stop loss reimbursement eligibility Assist in preparation and submission of stop loss claims to carriers, ensuring compliance with contract terms Monitor reimbursements and maintain status updates on pending claims Collaborate with internal departments (Claims, Care Management, Finance) to gather documentation Liaise with stop loss carriers to resolve claim issues and provide necessary support Maintain detailed records in accordance with regulatory and HIPAA standards Identify process inefficiencies and recommend improvements to optimize claims cycle time Qualifications Bachelor's degree in Business, Finance, Health Administration, or related field (preferred) 2+ years of experience in stop loss claims or TPA operations Strong working knowledge of self-funded health plans and stop loss contracts Advanced Excel skills; proficiency in data analytics tools a plus Exceptional attention to detail and organizational skills Excellent communication and relationship management abilities Preferred Qualifications Familiarity with ICD-10, CPT, and medical coding terminology Familiarity with LuminX or QicLink platforms Ability to interpret legal and contractual language Experience with claim adjudication systems or benefit platforms Independent and proactive problem-solving mindset Equal Employment Opportunity Policy Statement Lucent Health is an Equal Opportunity Employer that does not discriminate based on actual or perceived race, color, creed, religion, alienage or national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth and related medical conditions), gender identity, gender expression, transgender status, sexual orientation, marital status, military service and veteran status.

About Lucent Health Lucent Health combines top-tier claims management with a compassionate, human-focused, data-driven care management solution. This approach helps self-insured employers provide care management that enables health plan participants to make smarter, cost-saving healthcare decisions. Continuous data analytics offer ongoing insights, ensuring participants receive the right care, at the right cost, at the right time. Join us as we build a company that aims to be a better health benefits partner for self-insured employers. Company Culture We believe that the success of Lucent Health relies on having employees who are honest, ethical and hardworking. These values are the foundation of Lucent Health. Honest Transparent Communication: be open and clear in all interactions without withholding crucial information Integrity: ensure accuracy in reporting, work outputs and any tasks assigned Truthfulness: provide honest feedback and report any issues or challenges as they arise Trustworthiness: build and maintain trust by consistently demonstrating reliable behavior Ethical Fair Decision Making: ensure all actions and decisions respect company policies and values Accountability: own up to mistakes and take responsibility for rectifying them Respect: treat colleagues, clients and partners with fairness and dignity Confidentiality: safeguard sensitive information and avoid conflicts of interest Hardworking Consistency: meet or exceed deadlines, maintaining high productivity levels Proactiveness: take initiative to tackle challenges without waiting to be asked Willingness: voluntarily offer to assist in additional projects or tasks when needed Adaptability: work efficiently under pressure or in changing environments Summary: The Manager- Check Run oversees and manages the end-to-end process of generating, reviewing, approving, and distributing claim payment checks and electronic funds transfers (EFTs) for a health insurance organization. This role ensures accuracy, compliance with regulatory requirements, timeliness of payments, and coordination across finance, claims, and IT teams. They are responsible for safeguarding the integrity of payment processes, maintaining proper audit documentation, and ensuring that payments are issued according to plan sponsor agreements and company policies. Responsibilities: Plan, schedule, and execute weekly, bi-weekly, and ad-hoc check runs for provider, member, and vendor claim payments. Review and reconcile payment batches to ensure accuracy of amounts, payee information, and claim data. Coordinate with claims operations to resolve any discrepancies prior to payment release. Oversee the generation of both physical checks and EFT/ACH transactions. Ensure all check runs comply with federal, state, and plan-specific payment regulations. Maintain detailed documentation for internal controls and external audits (e.g., HIPAA, SOC, NAIC). Manage positive pay files and coordinate with banking partners to prevent fraud. Serve as the primary liaison between Claims, Finance, IT, and banking partners for payment processes. Communicate payment schedules and any delays to internal stakeholders. Support vendor and provider inquiries related to payment status or issues. Develop and maintain standard operating procedures (SOPs) for check run and payment processes. Identify opportunities to streamline workflows and improve payment accuracy and timeliness. Implement automation or system enhancements in coordination with IT and software vendors. Oversee payment processing staff (if applicable), providing training, guidance, and performance feedback. Qualifications: Bachelor's degree in Finance, Accounting, Business Administration, or related field; or equivalent work experience. 3-5 years of experience in payment processing, accounts payable, or claims finance operations in a health insurance or healthcare environment. Strong understanding of healthcare claims payment cycles, EOB/EOP generation, and provider/member payment regulations. Familiarity with HIPAA and other healthcare compliance requirements. Proficiency with claims administration systems and accounting software (e.g., Facets, QNXT, Javelina, Great Plains, etc.). Strong attention to detail and accuracy. Excellent communication and organizational skills. Preferred Qualifications: Supervisory experience. Experience with positive pay processes and fraud prevention tools. Knowledge of electronic payment file formats (ACH, 835/ERA, 837). Equal Employment Opportunity Policy Statement Lucent Health is an Equal Opportunity Employer that does not discriminate based on actual or perceived race, color, creed, religion, alienage or national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth and related medical conditions), gender identity, gender expression, transgender status, sexual orientation, marital status, military service and veteran status.

About Lucent Health Lucent Health combines top-tier claims management with a compassionate, human-focused, data-driven care management solution. This approach helps self-insured employers provide care management that enables health plan participants to make smarter, cost-saving healthcare decisions. Continuous data analytics offer ongoing insights, ensuring participants receive the right care, at the right cost, at the right time. Join us as we build a company that aims to be a better health benefits partner for self-insured employers. Company Culture We believe that the success of Lucent Health relies on having employees who are honest, ethical and hardworking. These values are the foundation of Lucent Health. Honest Transparent Communication: be open and clear in all interactions without withholding crucial information Integrity: ensure accuracy in reporting, work outputs and any tasks assigned Truthfulness: provide honest feedback and report any issues or challenges as they arise Trustworthiness: build and maintain trust by consistently demonstrating reliable behavior Ethical Fair Decision Making: ensure all actions and decisions respect company policies and values Accountability: own up to mistakes and take responsibility for rectifying them Respect: treat colleagues, clients and partners with fairness and dignity Confidentiality: safeguard sensitive information and avoid conflicts of interest Hardworking Consistency: meet or exceed deadlines, maintaining high productivity levels Proactiveness: take initiative to tackle challenges without waiting to be asked Willingness: voluntarily offer to assist in additional projects or tasks when needed Adaptability: work efficiently under pressure or in changing environments Summary The Case Manager shall work with the entire team to provide appropriate, comprehensive, and proactive onsite and telephonic case management services and to promote the provision of only the highest quality, most appropriate, cost-effective healthcare to plan participants with chronic or catastrophic illnesses or injuries, in accordance with applicable laws, the CCM/CMSA Standards of Practice, the policies and procedures according to the AAHC/URAC Guidelines. Experience and certification in diabetes management (such as Certified Diabetic Educator) is a strong preference for this role. The right candidate will be an RN with a CDE certification, or an RN with experience managing diabetes and willing to obtain a CDE certification Responsibilities: The Case Manager, under the direction and supervision of a Certified Case Management (CCM) Professional and acting in a Patient Advocate capacity and according to AAHC/URAC standards, shall perform all phases of the case management process, which shall include: Defines role and scope of activities to the patient in a comprehensible manner. Communicates to the patient that the information gathered will be shared with the payer. Gathers consent for case management activities. Determines individual needs based on an assessment that identifies all significant needs related to the Medical condition and care Works in a holistic manner, considering both medical and psychosocial issues. Identifies issues that might interfere with the provision of the highest quality, most appropriate, cost-effective care. Keeps in mind that a thorough, objective assessment is necessary to a successful outcome. Creates an individualized plan of action based on the assessment, which facilitates the coordination of appropriate and necessary treatment, and services required by the patient. Gives consideration, in developing the plan, to the benefit plan design/coverage options. Sets appropriate, measurable goals. Provides the patient with information to make "informed" decisions, empowering and encouraging the patient to make his own decisions through including him in the planning process. Develops contingency plans. Develops a plan, which advocates for the patient and maximizes benefit dollars. Researches and includes costs of services and use of community resources in plan design. Implements a plan that is based on the assessment. Skillfully negotiates and coordinates care based on the plan developed. Identifies and coordinates resources to ensure success of the plan. Works within the health plan provisions. Refers to only those providers that are familiar or researched to ensure high quality (either through personal knowledge/experience, onsite inspections, conversations with providers, review of accreditations and credentials, networking with other case managers, review of outcomes, statistics, payer, and patient satisfaction). Monitors the provision of the coordinated plan. Evaluates plan on a regular basis to determine effectiveness, patient satisfaction, provider comfort, payer satisfaction, if the plan is meeting the needs of all involved parties (but most particularly-the patient's needs) cost effectiveness, patient compliance with treatment, and the impact on the patient's quality of life. Determines if revisions are required due to changes in medical condition, family status, insurance coverage, etc. Qualifications: Registered Nurse with a minimum of 5 years Clinical Experience Credentials such as CCM/CRRN, OCN or other pertinent certifications (preferred) Excellent written, telephone, and computer skills Positive, proactive, team-oriented approach/attitude Time management and organizational skills, flexible, with the ability to work independently Active, unrestricted multi-state license Recent clinical experience Preferred : Certified Diabetic Educator Equal Employment Opportunity Policy Statement Lucent Health is an Equal Opportunity Employer that does not discriminate based on actual or perceived race, color, creed, religion, alienage or national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth and related medical conditions), gender identity, gender expression, transgender status, sexual orientation, marital status, military service and veteran status.

About Lucent Health Lucent Health combines top-tier claims management with a compassionate, human-focused, data-driven care management solution. This approach helps self-insured employers provide care management that enables health plan participants to make smarter, cost-saving healthcare decisions. Continuous data analytics offer ongoing insights, ensuring participants receive the right care, at the right cost, at the right time. Join us as we build a company that aims to be a better health benefits partner for self-insured employers. Company Culture We believe that the success of Lucent Health relies on having employees who are honest, ethical and hardworking. These values are the foundation of Lucent Health. Honest Transparent Communication: be open and clear in all interactions without withholding crucial information Integrity: ensure accuracy in reporting, work outputs and any tasks assigned Truthfulness: provide honest feedback and report any issues or challenges as they arise Trustworthiness: build and maintain trust by consistently demonstrating reliable behavior Ethical Fair Decision Making: ensure all actions and decisions respect company policies and values Accountability: own up to mistakes and take responsibility for rectifying them Respect: treat colleagues, clients and partners with fairness and dignity Confidentiality: safeguard sensitive information and avoid conflicts of interest Hardworking Consistency: meet or exceed deadlines, maintaining high productivity levels Proactiveness: take initiative to tackle challenges without waiting to be asked Willingness: voluntarily offer to assist in additional projects or tasks when needed Adaptability: work efficiently under pressure or in changing environments Summary: We are looking for a skilled healthcare Check Run Analyst (Payment Posting) for the set-up, maintenance, and completion of our clients' check runs. The ideal person is responsible for the maintenance of the check registers, and the maintenance of the check run guidelines and schedules. The individual must be able to efficiently multi-task and prioritize in performing the responsibilities listed below. Responsibilities: Daily servicing of client requests via email and telephone contacts Receive and interpret data; enter information into the benefits processing system Run daily and monthly reports for our clients, as needed Run daily flex and disability check runs Interface with clients, suppliers, and/or company employees in other departments on a regular basis to give or exchange information Additional duties as assigned Qualifications Bachelor's degree in Business, Finance, Health Administration, or related field (preferred) Insatiable appetite for attention to details, working with numbers, and organization 3 or more years' experience reconciling and balancing financial accounts Successfully manage check-runs and post payments to fund the right client accounts 3 years minimum general accounting experience in an administrative financial role 3 years minimum proficiency in the use of computer databases and applications including the Microsoft Office Suite (e.g., Outlook, Word, and Excel) Good interpersonal skills and passion to interact with others; internally and externally Must be able to perform with a sense of urgency and can prioritize multiple tasks Experience and understanding of Insurance carrier environment, preferred Experience and understanding of Insurance carrier healthcare claims, a plus Administrative Financial Services: 3 years (Preferred) Reconciling and balancing financial accounts: 3 years (Preferred) Payment Processing and Funding: 3 years (Preferred) High school or equivalent (Preferred) Familiarity with ICD-10, CPT, and medical coding terminology Familiarity with LuminX or QicLink platforms Equal Employment Opportunity Policy Statement: Lucent Health Solutions, Inc. is an Equal Opportunity Employer that does not discriminate based on actual or perceived race, creed, color, religion, alienage or national origin, ancestry, citizenship status, age, disability or handicap, sex, marital status, veteran status, sexual orientation, genetic information, gender identity, gender expression, transgender status, arrest record, or any other characteristic protected by applicable federal, state or local laws. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.

About Lucent Health Lucent Health combines top-tier claims management with a compassionate, human-focused, data-driven care management solution. This approach helps self-insured employers provide care management that enables health plan participants to make smarter, cost-saving healthcare decisions. Continuous data analytics offer ongoing insights, ensuring participants receive the right care, at the right cost, at the right time. Join us as we build a company that aims to be a better health benefits partner for self-insured employers. Company Culture We believe that the success of Lucent Health relies on having employees who are honest, ethical and hardworking. These values are the foundation of Lucent Health. Honest Transparent Communication: be open and clear in all interactions without withholding crucial information Integrity: ensure accuracy in reporting, work outputs and any tasks assigned Truthfulness: provide honest feedback and report any issues or challenges as they arise Trustworthiness: build and maintain trust by consistently demonstrating reliable behavior Ethical Fair Decision Making: ensure all actions and decisions respect company policies and values Accountability: own up to mistakes and take responsibility for rectifying them Respect: treat colleagues, clients and partners with fairness and dignity Confidentiality: safeguard sensitive information and avoid conflicts of interest Hardworking Consistency: meet or exceed deadlines, maintaining high productivity levels Proactiveness: take initiative to tackle challenges without waiting to be asked Willingness: voluntarily offer to assist in additional projects or tasks when needed Adaptability: work efficiently under pressure or in changing environments Summary A Salesforce Administrator is responsible for managing and optimizing the Salesforce platform to meet business needs, ensuring effective utilization of the CRM system, and providing support and training to users. Responsibilities User Management: Manage user accounts, profiles, roles, and permissions to ensure secure access to Salesforce data. System Configuration: Customize Salesforce to fit the organization's needs, including creating and managing fields, views, reports, dashboards, and workflows. Data Management: Perform database maintenance tasks, including data cleansing, duplicate management, and ensuring data integrity. Training and Support: Provide training and support to end-users, helping them effectively utilize Salesforce tools and features. Collaboration: Work closely with stakeholders to gather requirements and translate them into system solutions that enhance business processes. System Upgrades: Evaluate, install, and manage Salesforce updates and add-ons to keep the system current and efficient. Reporting and Analytics: Develop customized reports and dashboards to monitor data quality and business performance metrics. Qualifications Experience: Proven experience in Salesforce administration, with a solid understanding of business operations and analytical capabilities. Certifications: Salesforce Administrator certification is often preferred or required. Technical Skills: Strong technical knowledge of Salesforce software, including its functionalities and best practices for configuration and management. Problem-Solving Skills: Ability to troubleshoot and resolve technical issues that may arise within the Salesforce platform. Communication Skills: Excellent interpersonal skills to liaise with various stakeholders and effectively communicate technical concepts to non-technical users. Equal Employment Opportunity Policy Statement Lucent Health is an Equal Opportunity Employer that does not discriminate based on actual or perceived race, color, creed, religion, alienage or national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth and related medical conditions), gender identity, gender expression, transgender status, sexual orientation, marital status, military service and veteran status.

Job Description About Lucent Health Lucent Health combines top-tier claims management with a compassionate, human-focused, data-driven care management solution. This approach helps self-insured employers provide care management that enables health plan participants to make smarter, cost-saving healthcare decisions. Continuous data analytics offer ongoing insights, ensuring participants receive the right care, at the right cost, at the right time. Join us as we build a company that aims to be a better health benefits partner for self-insured employers. Company Culture We believe that the success of Lucent Health relies on having employees who are honest, ethical and hardworking. These values are the foundation of Lucent Health. Honest Transparent Communication: be open and clear in all interactions without withholding crucial information Integrity: ensure accuracy in reporting, work outputs and any tasks assigned Truthfulness: provide honest feedback and report any issues or challenges as they arise Trustworthiness: build and maintain trust by consistently demonstrating reliable behavior Ethical Fair Decision Making: ensure all actions and decisions respect company policies and values Accountability: own up to mistakes and take responsibility for rectifying them Respect: treat colleagues, clients and partners with fairness and dignity Confidentiality: safeguard sensitive information and avoid conflicts of interest Hardworking Consistency: meet or exceed deadlines, maintaining high productivity levels Proactiveness: take initiative to tackle challenges without waiting to be asked Willingness: voluntarily offer to assist in additional projects or tasks when needed Adaptability: work efficiently under pressure or in changing environments Summary The Stop Loss Analyst plays a pivotal role in managing financial risk associated with self-funded health plans. This position supports the underwriting and claims processes by evaluating large claims, tracking stop loss reimbursement trends, and ensuring accurate and timely submissions. Ideal candidates will combine analytical rigor with industry knowledge to protect the TPA and its clients from catastrophic claims exposure. Responsibilities Evaluate large medical and pharmacy claims for stop loss reimbursement eligibility Assist in preparation and submission of stop loss claims to carriers, ensuring compliance with contract terms Monitor reimbursements and maintain status updates on pending claims Collaborate with internal departments (Claims, Care Management, Finance) to gather documentation Liaise with stop loss carriers to resolve claim issues and provide necessary support Maintain detailed records in accordance with regulatory and HIPAA standards Identify process inefficiencies and recommend improvements to optimize claims cycle time Qualifications Bachelor's degree in Business, Finance, Health Administration, or related field (preferred) 2+ years of experience in stop loss claims or TPA operations Strong working knowledge of self-funded health plans and stop loss contracts Advanced Excel skills; proficiency in data analytics tools a plus Exceptional attention to detail and organizational skills Excellent communication and relationship management abilities Preferred Qualifications Familiarity with ICD-10, CPT, and medical coding terminology Familiarity with LuminX or QicLink platforms Ability to interpret legal and contractual language Experience with claim adjudication systems or benefit platforms Independent and proactive problem-solving mindset Equal Employment Opportunity Policy Statement Lucent Health is an Equal Opportunity Employer that does not discriminate based on actual or perceived race, color, creed, religion, alienage or national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth and related medical conditions), gender identity, gender expression, transgender status, sexual orientation, marital status, military service and veteran status.

About Lucent Health Lucent Health combines top-tier claims management with a compassionate, human-focused, data-driven care management solution. This approach helps self-insured employers provide care management that enables health plan participants to make smarter, cost-saving healthcare decisions. Continuous data analytics offer ongoing insights, ensuring participants receive the right care, at the right cost, at the right time. Join us as we build a company that aims to be a better health benefits partner for self-insured employers. Company Culture We believe that the success of Lucent Health relies on having employees who are honest, ethical and hardworking. These values are the foundation of Lucent Health. Honest Transparent Communication: be open and clear in all interactions without withholding crucial information Integrity: ensure accuracy in reporting, work outputs and any tasks assigned Truthfulness: provide honest feedback and report any issues or challenges as they arise Trustworthiness: build and maintain trust by consistently demonstrating reliable behavior Ethical Fair Decision Making: ensure all actions and decisions respect company policies and values Accountability: own up to mistakes and take responsibility for rectifying them Respect: treat colleagues, clients and partners with fairness and dignity Confidentiality: safeguard sensitive information and avoid conflicts of interest Hardworking Consistency: meet or exceed deadlines, maintaining high productivity levels Proactiveness: take initiative to tackle challenges without waiting to be asked Willingness: voluntarily offer to assist in additional projects or tasks when needed Adaptability: work efficiently under pressure or in changing environments Summary: The Case Manager shall work with the entire team to provide appropriate, comprehensive, and proactive onsite and telephonic case management services and to promote the provision of only the highest quality, most appropriate, cost-effective healthcare to plan participants with chronic or catastrophic illnesses or injuries, in accordance with applicable laws, the CCM/CMSA Standards of Practice, the company policies and procedures according to the AAHC/URAC Guidelines. Responsibilities: The Case Manager, under the direction and supervision of a Certified Case Management (CCM) Professional and acting in a Patient Advocate capacity and according to AAHC/URAC standards, The Case Manager shall perform all phases of the case management process, which shall include: Defines role and scope of activities to the patient in a comprehensible manner. Communicates to the patient that the information gathered will be shared with the payer. Gathers consent for case management activities. Determines individual needs based on an assessment that identifies all significant needs related to the Medical condition and care Works in a holistic manner, considering both medical and psychosocial issues. Identifies issues that might interfere with the provision of the highest quality, most appropriate, cost-effective care. Creates an individualized plan of action based on the assessment, which facilitates the coordination of appropriate and necessary treatment, and services required by the patient. Gives consideration, in developing the plan, to the benefit plan design/coverage options. Sets appropriate, measurable goals. Provides the patient with information to make "informed" decisions, empowering and encouraging the patient to make his own decisions through including him in the planning process. Develops contingency plans. Facilitates communication of the patient's wishes to all members of the health care team. When appropriate, discuss advanced directives with patient/family. Obtains the acceptance of all parties (patient, family, payer, and providers) prior to instituting the plan. Works within the health plan provisions. Refers to only those providers that are familiar or researched to ensure high quality (either through personal knowledge/experience, onsite inspections, conversations with providers, review of accreditations and credentials, networking with other case managers, review of outcomes, statistics, payer, and patient satisfaction). Evaluates plan on a regular basis to determine effectiveness, patient satisfaction, provider comfort, payer satisfaction, if the plan is meeting the needs of all involved parties (but most particularly-the patient's needs) cost effectiveness, patient compliance with treatment, and the impact on the patient's quality of life. Determines if revisions are required due to changes in medical condition, family status, insurance coverage, etc. Maintains well-organized, objective, factual, clear, and concise documentation that reflects what was done on the cases and why it was done, adhering to policies regarding timeliness. Performs as a patient advocate, in an ethical manner always, incorporating case management concepts and following industry standards and guidelines. Becomes involved in the case management process as early as possible following the onset or diagnosis and maintains involvement throughout the course of the illness or injury Qualifications: Registered Nurse with a minimum of 5 years Clinical Experience Credentials such as CCM/CRRN, OCN or other pertinent certifications (preferred) Excellent written, telephone, and computer skills Positive, proactive, team-oriented approach/attitude Time management and organizational skills, flexible, with the ability to work independently. Active, unrestricted multi-state license Recent clinical experience Equal Employment Opportunity Policy Statement Lucent Health is an Equal Opportunity Employer that does not discriminate based on actual or perceived race, color, creed, religion, alienage or national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth and related medical conditions), gender identity, gender expression, transgender status, sexual orientation, marital status, military service and veteran status.

Job Description About Lucent Health Lucent Health combines top-tier claims management with a compassionate, human-focused, data-driven care management solution. This approach helps self-insured employers provide care management that enables health plan participants to make smarter, cost-saving healthcare decisions. Continuous data analytics offer ongoing insights, ensuring participants receive the right care, at the right cost, at the right time. Join us as we build a company that aims to be a better health benefits partner for self-insured employers. Company Culture We believe that the success of Lucent Health relies on having employees who are honest, ethical and hardworking. These values are the foundation of Lucent Health. Honest Transparent Communication: be open and clear in all interactions without withholding crucial information Integrity: ensure accuracy in reporting, work outputs and any tasks assigned Truthfulness: provide honest feedback and report any issues or challenges as they arise Trustworthiness: build and maintain trust by consistently demonstrating reliable behavior Ethical Fair Decision Making: ensure all actions and decisions respect company policies and values Accountability: own up to mistakes and take responsibility for rectifying them Respect: treat colleagues, clients and partners with fairness and dignity Confidentiality: safeguard sensitive information and avoid conflicts of interest Hardworking Consistency: meet or exceed deadlines, maintaining high productivity levels Proactiveness: take initiative to tackle challenges without waiting to be asked Willingness: voluntarily offer to assist in additional projects or tasks when needed Adaptability: work efficiently under pressure or in changing environments Summary: We are looking for a skilled healthcare Check Run Analyst (Payment Posting) for the set-up, maintenance, and completion of our clients' check runs. The ideal person is responsible for the maintenance of the check registers, and the maintenance of the check run guidelines and schedules. The individual must be able to efficiently multi-task and prioritize in performing the responsibilities listed below. Responsibilities: Daily servicing of client requests via email and telephone contacts Receive and interpret data; enter information into the benefits processing system Run daily and monthly reports for our clients, as needed Run daily flex and disability check runs Interface with clients, suppliers, and/or company employees in other departments on a regular basis to give or exchange information Additional duties as assigned Qualifications Bachelor's degree in Business, Finance, Health Administration, or related field (preferred) Insatiable appetite for attention to details, working with numbers, and organization 3 or more years' experience reconciling and balancing financial accounts Successfully manage check-runs and post payments to fund the right client accounts 3 years minimum general accounting experience in an administrative financial role 3 years minimum proficiency in the use of computer databases and applications including the Microsoft Office Suite (e.g., Outlook, Word, and Excel) Good interpersonal skills and passion to interact with others; internally and externally Must be able to perform with a sense of urgency and can prioritize multiple tasks Experience and understanding of Insurance carrier environment, preferred Experience and understanding of Insurance carrier healthcare claims, a plus Administrative Financial Services: 3 years (Preferred) Reconciling and balancing financial accounts: 3 years (Preferred) Payment Processing and Funding: 3 years (Preferred) High school or equivalent (Preferred) Familiarity with ICD-10, CPT, and medical coding terminology Familiarity with LuminX or QicLink platforms Equal Employment Opportunity Policy Statement: Lucent Health Solutions, Inc. is an Equal Opportunity Employer that does not discriminate based on actual or perceived race, creed, color, religion, alienage or national origin, ancestry, citizenship status, age, disability or handicap, sex, marital status, veteran status, sexual orientation, genetic information, gender identity, gender expression, transgender status, arrest record, or any other characteristic protected by applicable federal, state or local laws. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.

Job Description About Lucent Health Lucent Health combines top-tier claims management with a compassionate, human-focused, data-driven care management solution. This approach helps self-insured employers provide care management that enables health plan participants to make smarter, cost-saving healthcare decisions. Continuous data analytics offer ongoing insights, ensuring participants receive the right care, at the right cost, at the right time. Join us as we build a company that aims to be a better health benefits partner for self-insured employers. Company Culture We believe that the success of Lucent Health relies on having employees who are honest, ethical and hardworking. These values are the foundation of Lucent Health. Honest Transparent Communication: be open and clear in all interactions without withholding crucial information Integrity: ensure accuracy in reporting, work outputs and any tasks assigned Truthfulness: provide honest feedback and report any issues or challenges as they arise Trustworthiness: build and maintain trust by consistently demonstrating reliable behavior Ethical Fair Decision Making: ensure all actions and decisions respect company policies and values Accountability: own up to mistakes and take responsibility for rectifying them Respect: treat colleagues, clients and partners with fairness and dignity Confidentiality: safeguard sensitive information and avoid conflicts of interest Hardworking Consistency: meet or exceed deadlines, maintaining high productivity levels Proactiveness: take initiative to tackle challenges without waiting to be asked Willingness: voluntarily offer to assist in additional projects or tasks when needed Adaptability: work efficiently under pressure or in changing environments Summary A Salesforce Administrator is responsible for managing and optimizing the Salesforce platform to meet business needs, ensuring effective utilization of the CRM system, and providing support and training to users. Responsibilities User Management: Manage user accounts, profiles, roles, and permissions to ensure secure access to Salesforce data. System Configuration: Customize Salesforce to fit the organization's needs, including creating and managing fields, views, reports, dashboards, and workflows. Data Management: Perform database maintenance tasks, including data cleansing, duplicate management, and ensuring data integrity. Training and Support: Provide training and support to end-users, helping them effectively utilize Salesforce tools and features. Collaboration: Work closely with stakeholders to gather requirements and translate them into system solutions that enhance business processes. System Upgrades: Evaluate, install, and manage Salesforce updates and add-ons to keep the system current and efficient. Reporting and Analytics: Develop customized reports and dashboards to monitor data quality and business performance metrics. Qualifications Experience: Proven experience in Salesforce administration, with a solid understanding of business operations and analytical capabilities. Certifications: Salesforce Administrator certification is often preferred or required. Technical Skills: Strong technical knowledge of Salesforce software, including its functionalities and best practices for configuration and management. Problem-Solving Skills: Ability to troubleshoot and resolve technical issues that may arise within the Salesforce platform. Communication Skills: Excellent interpersonal skills to liaise with various stakeholders and effectively communicate technical concepts to non-technical users. Equal Employment Opportunity Policy Statement Lucent Health is an Equal Opportunity Employer that does not discriminate based on actual or perceived race, color, creed, religion, alienage or national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth and related medical conditions), gender identity, gender expression, transgender status, sexual orientation, marital status, military service and veteran status.