Plan Setup Specialist

Job Title: Plan Setup Specialist

Max Bill Rate: $20-$23

Work Hours: 8 AM – 5 PM

Start Date: ASAP

Length of Assignment: Through 12/31/2025

Location: Hybrid – Mason, OH (2-3 days in office)

Job Summary:

The Plan Setup Specialist will be responsible for setting up and maintaining managed vision care clients in the core administration system. This role involves ensuring accurate data entry, processing system updates, and conducting audits to maintain compliance with corporate and industry standards. The specialist will also provide administrative support to the Plan Setup team, assisting with work assignments, reporting, and quality control measures.

Key Responsibilities:

• Set up new Managed Care groups in the claims processing system.
• Fulfill requested revisions to existing Managed Care groups (excluding Reseller product changes).
• Create standard products in the system using the Product Key Sheet method.
• Conduct audits on client setup or maintenance requests (excluding complex product configurations).
• Adhere to established corporate and industry audit controls, such as SOX and SSAE 18.
• Support daily administrative tasks, including evaluating new requests, coordinating work assignments, preparing reports, and performing audits.

Required Skills & Qualifications:

• Experience: 1-3 years of data entry or related experience.
• Technical Skills: Proficiency in Microsoft Word and Excel; general computer skills required.
• Soft Skills: Strong communication, analytical skills, and ability to work well in a team setting.
• Preferred Experience: Previous system testing or auditing experience; experience in the healthcare industry is a plus.
• Education: College degree or equivalent experience required.

Mandatory Compliance Training:

All temporary employees must complete the following courses:

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

Additional training may include Model of Care, ODAG, FSL Fraud Integral Staff training, and CA Fair Claims.

This hybrid position requires in-office presence 2-3 times per week in Mason, OH. If interested, please reach out for further details.