Plan Build Coordinator

🕒 3 dias atrás

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Point C

SiteLinkedInTodas as Vagas

201 - 500 funcionários

🛡️ Seguros

💼 Consultoria

📦 Logística

Insurance • Consulting • Logistics

A Point C é uma parceira confiável em benefícios de saúde que oferece soluções significativas para corretores e seus clientes auto-segurados. A empresa é especializada na administração de planos de benefícios, gestão eficaz de custos médicos e garante uma experiência de alto valor para os membros. Com foco na integração de fornecedores e insights baseados em dados, a Point C visa simplificar o processo de benefícios enquanto proporciona acesso a cuidados de qualidade e inovadoras ferramentas móveis para seus clientes e seus funcionários.

Descrição

• Develop, configure, and maintain healthcare plan designs and benefit configurations in various systems • Ensure plan configurations support auto adjudication and meet regulatory and compliance requirements • Review and update plan configurations for changes in healthcare policies and regulations • Oversee integration and interoperability of healthcare systems to streamline auto adjudication • Facilitate system upgrades, patches, and maintenance • Collaborate with IT and other departments to implement technologies and enhancements • Test plan configurations for accurate and efficient claims adjudication • Identify and resolve adjudication discrepancies and issues • Create and document testing protocols and procedures • Gather requirements from internal and external stakeholders and ensure configurations meet organizational and client needs • Serve as a subject matter expert on plan building and system configuration • Communicate project status, issues, and resolutions to stakeholders • Maintain documentation of plan configurations, system changes, and testing procedures • Use data and analytics to identify trends and improvement opportunities

🎯 Requisitos

• Associate’s degree in healthcare administration, information systems, or a related field • Minimum of 2 years of experience in plan building, system configuration, and claims adjudication in the healthcare industry • Strong knowledge of healthcare policies, regulations, and compliance requirements • Proficiency in healthcare management systems and software • Excellent problem-solving skills and attention to detail • Effective communication and interpersonal skills • Ability to work in a fast-paced environment and manage multiple projects simultaneously • Experience with auto adjudication systems and technologies preferred • Certification in healthcare information systems or related fields preferred • Proven track record of successful system integration and optimization projects preferred

🏖️ Benefícios

• Comprehensive medical, dental, vision, and life insurance coverage • 401(k) retirement plan with employer match • Health Savings Account (HSA) & Flexible Spending Accounts (FSAs) • Paid time off (PTO) and disability leave • Employee Assistance Program (EAP) • Certain roles may be eligible for additional compensation, including bonuses and merit increases • Individual compensation commensurate with experience and qualifications