Configuration Specialist

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

📋 Description

• Analyze and convert business requirements into adjustable components.

• Create solutions that promote highly automated and precise outcomes.

• Develop, sustain, and implement configurations for benefits, pricing, member products/plans, premium billing, correspondence, business rules, and workflows.

• Collaborate with third-party industry software to ensure rules operate correctly.

• Engage with testers, operations, and clients to confirm results align with requirements.

• Continuously assess the configuration environment and ensure it is updated with the latest releases.

• Manage environment updates as necessary.

• Record configuration modifications.

• Assist in troubleshooting issues.

• Monitor the completion and rollout of changes within designated timelines.

• Protect PHI and PII in compliance with company policies and HIPAA regulations.

⛳️ Requirements

• 2–6 years of experience in the healthcare sector within the payer segment, including Medicare Advantage or Managed Medicaid, or with other healthcare service providers.

• Proven experience in establishing and maintaining healthcare payor system configurations is essential.

• Understanding of Medicare regulations and the capability to translate them into business outcomes.

• Strong SQL proficiency.

• Expertise in MS Excel and MS Access.

• Outstanding interpersonal, listening, written, and verbal communication skills.

• Keen attention to detail.

• Capacity to work under tight deadlines.

• Experience with commercial lines of business is an advantage.

• Familiarity with Healthcare EDI files is a plus.

• Knowledge of Medicaid regulations is beneficial.

• A bachelor's degree or equivalent is preferred.

• Adherence to company security, privacy, HIPAA, HITECH, and pertinent federal and state regulations.

• Ability to securely access, process, store, and transmit PHI and PII.

🏝️ Benefits

• Medical insurance

• Dental insurance

• Vision insurance

• 401(k) with match

• Life insurance

• Long-term disability (LTD)

• 5 weeks of vacation

• Paid holidays