Teams at SKYGEN USA

Serve as subject matter expert for provider contracting and network development: resolve escalations, conduct provider outreach and negotiations, deliver training and maintain knowledge base, perform market and cost analyses, manage contracts and campaigns, mentor junior staff, and support reporting and proprietary systems to ensure network adequacy and provider compliance.

Design, develop, maintain, and extend healthcare billing and enrollment software. Collaborate with architects and engineers on APIs and architecture, triage production issues, write unit tests, perform impact analysis, research solutions, follow secure coding practices, and mentor junior engineers on an Agile scrum team.

Perform daily and monthly audits of authorization case work to ensure SLA and regulatory compliance. Provide technical and administrative support for authorization processing, run SQL scripts to monitor SLA adherence, troubleshoot system/configuration issues, communicate audit findings, and recommend/implement process controls to resolve quality issues.