Medical Claims Business Operations Specialist
Location
Mason, OH | United States
Job description
We are looking for a Medical Claims Business Operations Specialist for a top retail company in Mason, Ohio. This position is hybrid and based our of Mason office.
Responsibilities: - Represent Product Configuration on cross-functional project teams to implement new Government/Medical-Surgical products
- 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 request 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 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.
Required Qualifications: - Bachelor’s degree or equivalent work experience
- 5+ years’ experience with health plans or medical claims
- 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
- Must live near Mason, Ohio as this is a hybrid position.
If you meet the required qualifications and are interested in this role, please apply today.
The Solomon Page DistinctionSolomon Page offers a comprehensive benefit program for hourly employees. We pride ourselves on offering medical, dental, 401(k), direct deposit and commuter benefits to our employees, including freelancers - which sets us apart in the industries we serve.
About Solomon PageFounded in 1990, Solomon Page is a specialty niche provider of staffing and executive search solutions across a wide array of functions and industries. The success of Solomon Page reflects an organic growth strategy supported by a highly entrepreneurial culture. Acting as a strategic partner to our clients and candidates, we focus on providing customized solutions and building long-term relationships based on trust, respect, and the consistent delivery of excellent results. For more information and additional opportunities, visit: solomonpage.com and connect with us on Facebook, and LinkedIn.
Opportunity Awaits.
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