Healthcare Plan Configuration Specialist
Job Summary
To optimize auto adjudication processes across all systems, the remote Plan Build Coordinator will develop, configure, and maintain healthcare plan designs and benefit configurations while ensuring compliance with regulations and facilitating system integrations.
Key responsibilities
- Develop, configure, and maintain healthcare plan designs and benefit configurations in various systems
- Ensure all plan configurations support auto adjudication and meet regulatory and compliance requirements
- Perform comprehensive testing of plan configurations to ensure accurate and efficient claims adjudication
Required qualifications
- Associate's degree in healthcare administration, information systems, or a related field
- Minimum of 2 years of experience in plan building, system configuration, and claims adjudication in the healthcare industry
- Strong knowledge of healthcare policies, regulations, and compliance requirements
- Proficiency in using healthcare management systems and software
- Experience with auto adjudication systems and technologies preferred
Complete Job Description
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