Claims Systems Configuration Associate

This is a fully remote position, open to applicants in United States.

📋 Description

• Execute claims systems testing tasks under the guidance of a mentor and/or Claims Systems Quality Review Supervisor.

• Utilize Jira and project management methodologies to track tickets for claims systems testing requests.

• Evaluate proprietary claim edits, industry-standard claim edits, and benefit rules for various claim products and programs.

• Review, coordinate, and outline claims systems testing for claims configuration specialists.

• Maintain documentation of testing activities in a Microsoft Excel tracker.

• Assess configuration changes to ensure claims processing aligns with established requirements.

• Employ SQL queries to examine configuration, testing, and claims data.

• Investigate claim processing issues and conduct root-cause analysis of claims configuration.

⛳️ Requirements

• High school diploma or GED is mandatory.

• An associate degree in a computer-related field is preferred.

• A minimum of 2 years of experience with claims and health care data is required.

• At least 1 year of experience in configuring medical claims systems is preferred.

• Familiarity with running basic queries using Microsoft SQL is necessary.

• Experience with Microsoft Access databases, including query execution and data manipulation, is preferred.

• Proficiency in Microsoft Excel, encompassing pivot tables, charts, and formulas, is required.

• Strong technical skills, critical thinking abilities, and effective communication skills are essential.

• A cable broadband or fiber optic internet connection with a minimum of 10Mbps download and 5Mbps upload speed is required for remote work.

🏝️ Benefits

• Eligibility for an annual bonus plan.

• Medical, vision, and dental benefits commence on the first day of employment.

• Access to well-being and behavioral health programs.

• Participation in a 401(k) plan.

• Company-paid life insurance coverage.

• Tuition reimbursement opportunities.

• A minimum of 18 days of paid time off each year.

• Paid holidays.

• Leaves of absence available.