About Job

Description/Comment:

Plan Setup Specialist

Job Summary:
Provides exceptional service and support to all client Providers/Locations through execution of provider/location database requests within established performance metrics.
Responsible for setting up and maintaining clients in the claims processing system.

Additional duties: Supporting the Plan Setup team by assisting with daily administrative duties, including evaluating new requests, coordinating work assignments, running/preparing management reports, performing audits, etc..

MAJOR DUTIES AND RESPONSIBILITIES

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.)

Specific Skills Needed:
Minimum of 1-3 years experience working in a data entry position
Proficient at working on a computer (requirement)
Experience using Microsoft Word and Microsoft Excel software (requirement)
Ability to work well in a team setting
Strong communication and analytical analysis skills required
Previous system testing or auditing experience a plus
Experience in the Healthcare industry a plus

Education:

College degree or experience required

There will actually be 5 courses that required for all temporary employees:
3 for Compliance purposes and 2 for HiTrust / Security requirements:

1. General Compliance
2. HIPAA
3. Fraud, Waste, and Abuse
4. Security Essentials
5. Introduction to Phishing

In addition; Model of Care, ODAG, FSL Fraud Integral Staff training, CA Fair Claims.

Notes:

HYBRID- MASON, OH - 2-3x in office

Job Type: Contract

Pay: $22.39 - $25.50 per hour

Expected hours: 40 per week

Schedule: