Job Title: Healthcare Specialist/Benefits Configuration Specialist

Job Description

• Medical benefits – Have a member who is eligible through their IPA, when they enroll they have to be entered in our system and that will tell us what their copay is. Eligibility, etc.
• Go into HealthPlan website and there can be 8 different ones, go in there and pull by number which is EOC (evidence of coverage), review that, then configure the system to get claims based off that information
• Understanding and translating the EOC into the configuration world and understanding the setup in Q-NEX
•  Understanding what CPT codes apply to which categories and then aligning those on which ones are correct
• Navigating health plan portal, knowing where to find those EOC’s would be very helpful to have in prior experience
• Needs to be high level
• Understanding DOFR, that is part of the benefit, which is understanding who is responsible for co-payments. There is document for financial responsibility and its broken into 8 categories and candidate must know when to use each category

Additional Skills & Qualifications

• Must have expereince with the system QNX/QNXT
• Must have at least 2 years of experience in the industry
• Have knowledge of DOFR and EOC
• Must be familiar with CPT codes

Work Environment

• Remote work environment. Monday - Friday 8AM -5PM PST.

For immediate consideration, email your updated resume to olellis@ actalentservices.com along with a couple of reasons why you're a strong fit for the role.

Pay and Benefits

The pay range for this position is $25.00 - $36.00

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:

• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type

This is a fully remote position.

Application Deadline

This position will be accepting applications until Feb 4, 2025.

About Actalent

Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.

Diversity, Equity & Inclusion

At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:

• Hiring diverse talent
• Maintaining an inclusive environment through persistent self-reflection
• Building a culture of care, engagement, and recognition with clear outcomes
• Ensuring growth opportunities for our people

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.

Salary : $25 - $36