JOB SUMMARY
The Configuration Specialist is accountable for entering and maintaining demographic and contractual data within the claims processing system; works with various departments to answer questions about information configured within applicable databases.
ESSENTIAL FUNCTIONS OF THE ROLE
- Maintains database, utilizing data sources, to ensure data integrity within the claims processing system. Works in conjunction with other departments to enter data into the system and make modifications to existing configuration.
- Performs system configuration based on the business requirements.
- Provides help and help to users to resolve problems and issues in area of expertise.
- Provides help with both simple and complex administrative tasks, including but not limited to, entry and validation of data for many departments.
- Works in conjunction with the Compliance Department to update records as appropriate when notified of credible allegations of fraud and identifies any claims paid during the alleged period.
- Reviews quality reports. Updates records to bring configuration in line with company standards.
- Aids in the development of new policies and procedures needed as new issues arise, and helps in creating business and system requirements to improve the management of data.
KEY SUCCESS FACTORS
- Skill in the use of computers and associated software such as Microsoft Office.
- Exceptional data-backed skills.
- Experience with claims processing preferred.
- Health insurance experience preferred.
BENEFITS
Our competitive benefits package includes the following
- Immediate eligibility for health and welfare benefits
- 401(k) savings plan with dollar-for-dollar match up to 5%
- Tuition Reimbursement
- PTO accrual beginning Day
Note: Benefits may vary based on position type and/or level
QUALIFICATIONS
- EDUCATION - Associate's or 2 years of work experience above the minimum qualification
EXPERIENCE
- 2 Years of Experience