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Plan Setup Specialist

Real Soft Inc
Mason, OH Full Time
POSTED ON 12/28/2024
AVAILABLE BEFORE 2/28/2025
JOB TITLE: Plan Setup Specialist
Work hours: 8-5 pm
Start date: ASAP
Location: HYBRID- MASON, OH - 2-3x in office
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.) 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

EDUCATION/EXPERIENCE QUALIFICATIONS

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

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