Job Description :
Pay Range : $55hr - $60hr
Responsibilities :
- Represent Product Configuration on cross-functional project teams to implement new Government / Medical-Surgical product.
- Serve as the lead subject matter expert for Government / Medical-Surgical product configuration for the production team.
- Partner with IT Configuration on Global Configuration requirements, perform data analysis, prototyping, and testing support for Government client setup requests.
- Develop and document the standard operating procedures for Government / Medical-Surgical product configuration.
- Develop and train the team on the knowledge of Government / Medical-Surgical product configuration.
- Provide additional support working Commercial client setup and maintenance requests sent to the Plan Setup team when necessary.
- Perform audits on client setup or maintenance requests by following established team audit controls.
- Develop and maintain positive working relationships with team members and other stakeholders, including business partners at all levels of Eye Med leadership.
- Self-manage completion of work inventory in the Plan Setup production queues within established quality and turnaround time guidelines.
- Support the management team with misc. projects, resolving issues, and other duties as assigned.
Education and Experience :
- Bachelor’s degree or equivalent work experience.
- At least 5+ years’ experience with health plans or medical claim.
- Experience with Claims Processing, Medical Plan Benefit Configuration (Facets platform a plus).
- SQL and Database experience with basic queries.
- Excellent analytical and problem-solving skills.
- Strong communication and interpersonal skills.
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