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