IBM ACE Developer-Remote (W2)

• Respond promptly and accurately to inquiries from Customer Service
• Professionals, subscribers, providers, physicians and other insurance carriers regarding claims payments.
• Meet or exceed established quality and performance standards
• Determine suspended claim resolution methods by reviewing benefit eligibility, claims history and other information
• Escalate claims requiring specialized resolution to subject matter experts based on department policies and guidelines to

ensure the resolution

• Understand business requirement for the customer and provider segments with tailored solutions to their needs
• Identify system issues by documenting the issue, recommend potential solution and refer appropriate technical staff
• Work with designated Provider Services specialists to deliver services tailored to the provider services
• Review claims for possible “fraud and abuse” and send to Special Investigations Unit for additional investigation
• Use continuous improvement and knowledge of claims to drive efficiency and production gains; share best practices
• Coordinate with other insurance carriers and Medicare to determine payment liability
• Represent Claims interests on divisional or enterprise project teams
• Independently perform the analysis, design and development of high volume, low latency applications for mission critical

systems delivering high-availability and performance to best meet customer needs.

• Write well designed, testable, efficient code to support varied and more complex IT solutions
• Provide strong technical expertise and collaborate with other IT specialists to rapidly develop and deliver stunning solutions

that meets changing business needs.

• Perform all necessary discovery and fact finding to fully understand more complex business problems and opportunities and

independently execute all assignments.

• Evaluate options and make solution buy vs. build recommendations to management when requested.
• Analyze and recommend solutions to development and production issues while effectively communicating to the project team,

applicable vendors and/or the manager in a timely manner.

• Research and stay abreast of technology trends and IT best practices, with a focus on continuous learning and possible

application to the business.

• Provide direction and assistance to less experienced team members.

Do you have experience in Research?, Do you have a Bachelor’s degree?, * Experience in IBM ACE development is required

• Experience in IBM MQ, API development, XML, JSON, event-driven, Salesforce preferred.
• Bachelor’s degree or advanced degree (where required)
• 5+ years of experience in related field.
• In lieu of degree, 7+ years of experience in related field.

3.43.4 out of 5 stars Remote $55 - $60 an hour - Contract