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Job Details

Job Title
: Plan Setup Specialist
Required Skills
: Claims, Facets, Healthcare
Location
Duration
: Expected 3 months contract with possible extension

Job Description

Pay Rate: $24/hr.

Featured Benefits:

Medical Insurance in compliance with the ACA

401(k)

Sick leave in compliance with applicable state, federal, and local laws

Job Description:

Serve as a Specialist on the Plan Setup Team responsible for setting up and maintaining EyeMed’s managed vision care clients in our core administration system.

Job Responsibility:

  • Responsible for setting up new Managed Care groups in the claims system
  • Responsible for fulfilling requested revisions to existing Managed Care group in the claims system (except Reseller product changes)
  • Responsible for creating “standard” products in the system (using the Product Key Sheet method)
  • Responsible for performing audits on client setup or maintenance requests (excludes complex product configuration requests)
  • Follow the established corporate and industry audit controls (i.e. SOX, SSAE 18, etc.) when fulfilling setup and maintenance requests
  • Resolve client structure setup questions/issues sent to the team with minimal supervisor guidance
  • Maintain relationships with Implementation Managers and Account Managers to facilitate fulfillment of implementation questions and requests in a timely manner
  • Self-manage completion of work inventory in the Plan Setup production queues within established quality and turnaround time guidelines
  • Recommend process and system enhancements for the Plan Setup team to drive improvements to performance
  • Support the management team with misc. projects and resolving assigned Plan setup issues

Qualification:

  • College degree or equivalent experience required
  • Minimum of 1 year claims system experience, preferably in the Healthcare industry
  • Basic analytical and problem solving skills
  • Good communication and interpersonal skills
  • Ability to work independently and with others
  • Ability to manage more than one assigned tasks at the same time

Required Details

Experience
: 1-2 Years
Travel Required
: No
Clearance Required
: No

Contact Details

Contact person
: Uday Bhandary
Phone
: 678-675-1014
Website
: https://suntechnologies.com

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