EZ-CAP Technician II

Description

About Us:

Astiva Health, Inc. is a Medicare and HMO healthcare organization committed to delivering accessible, affordable, and high-quality care while improving outcomes for the diverse communities we serve. Through innovation, collaboration, and a strong focus on member-centered care, we strive to make a meaningful, lasting impact on healthcare delivery.

SUMMARY: The EZ-CAP Technician II provides operational and administrative support for EZ-CAP, EZ-NET, and EZ-CARE systems, focusing on user access, data updates, request intake, and task tracking under established procedures.

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following:

• •Performs advanced EZ-CAP configuration for contracts, benefits, fee schedules, and DOFRs.
• •Builds, audits, and maintains benefit structures, amendments, and related code sets.
• •Conducts claims testing, auditing, and troubleshooting to ensure configuration accuracy.
• •Interprets contract requirements and translates them into system rules.
• •Develops and executes test plans and validation documentation.
• •Serves as escalation support for Technician I staff.
• •Leads small configuration or optimization projects.
• •Identifies system risks and improvement opportunities and recommends solutions.
• •Maintains SOPs and configuration documentation.
• •Mentors and provides technical guidance to Technician I staff.
• •Coordinates with IT, Claims, Provider Relations, and Operations.
• •Manages assigned work with minimal supervision.
• •Performs other duties as assigned.

OTHER SKILLS and ABILITIES:

• •Ability to learn quickly and follow new procedures and workflows.
• •Team-oriented with strong attention to accuracy and documentation.
• •Entry-level problem-solving skills with appropriate escalation.
• •Able to communicate basic technical information effectively.

BENEFITS:

• •401(k)
• •Dental Insurance
• •Health Insurance
• •Life Insurance
• •Vision Insurance
• •Paid Time Off
• •Free catered lunches

Requirements

EDUCATION and/or EXPERIENCE :

• •Bachelor’s degree in healthcare, IT, or related field preferred but not required.
• •3–5 years of experience in Managed Care or healthcare-related roles.
• •Advanced EZ-CAP knowledge required, including configuration, testing, and validation.
• •Experience with claims adjudication, benefits, provider contracts, or system rule interpretation.
• •Strong communication, analytical, and troubleshooting skills.
• •Proficiency in Microsoft Office and project/task management tools.
• •Ability to manage complex priorities independently and lead assigned initiatives