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

📋 Description

• Assist in the execution of eligibility and accumulator file feeds, as well as interfaces, from the implementation phase through ongoing operations and maintenance.

• Ensure the accuracy, completeness, and timely delivery of claims extract file feeds to external stakeholders.

• Act as a daily resource for the data needs related to eligibility, accumulators, and claims extracts.

• Collaborate effectively with engineering, client success, implementations, benefit administration, and other internal teams.

• Oversee downstream vendor feeds and third-party integrations, escalating issues and providing troubleshooting support as necessary.

• Investigate and resolve inquiries or issues associated with eligibility, accumulators, and claims extract/data feeds.

• Maintain thorough and current documentation of processes and internal controls.

• Assume additional duties as business needs change.

⛳️ Requirements

• A Bachelor's degree is preferred; however, relevant experience may be considered for outstanding candidates.

• 2–4 years of experience in healthcare operations, PBM, health plan, or data/eligibility operations; entry-level candidates with strong analytical abilities are encouraged to apply.

• Highly detail-oriented and organized.

• A strong sense of ownership and accountability.

• Capable of thriving in a fast-paced environment with changing priorities.

• Willingness to learn new systems and platforms.

• Possess a consultative approach when interacting with internal and external stakeholders.

• Proficient in Excel.

• Ability to investigate and rectify data discrepancies.

• Experience with eligibility, accumulator, or claims file feeds.