Team Lead, Configuration Testing – RPA/Automation

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November 5

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CareSource

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Healthcare Insurance

CareSource is a health services company focused on providing affordable health insurance and healthcare solutions. It offers a wide range of plans including Medicaid, Marketplace, and Medicare Advantage, targeting low-income adults, families, children, pregnant women, elderly adults, and people with disabilities. Additionally, CareSource provides members with resources for COVID-19 support, dental, vision, and hearing benefits, as well as pharmacy services. The company emphasizes easy access to healthcare management through online platforms and a mobile app.

1001 - 5000 employees

Founded 30+ years

⚕️ Healthcare Insurance

📋 Description

• Responsible for day-to-day activities surrounding the knowledge and insight around testing of medical benefits, provider reimbursement, letters, claims workflow and clinical editing • Guide and direct successful completion of daily tasks • Responsible for onboarding, training and development of staff • Prioritize all work, requests and activities • Escalate any area of significant resource contention along with recommendation for resolution • Track issues and status to ensure proper follow-up, coordination with business area and provide solutions • Update project that configuration is involved with and coordinate any needed changes with manager • Provide management with ticket dashboards • Identify root cause of issues and appropriate pro-active resolution to reduce tickets in the future • Ensure ticket controls, communication and approvals are followed prior to system implementation • Maintain and support fee schedules and methodology is consistent with required standards • Provide oversight to vendor management tasks conducted by team members • Ensure timely responses and resolution • Assist in auditing system configuration to ensure accuracy and internal controls are in place to minimize potential fraud and abuse and any business issues.

🎯 Requirements

• Bachelor's Degree or equivalent years of relevant work experience is required • Minimum of three (3) years of health plan business or systems solutions experience is required • Exposure to Facets or equivalent system is preferred • Prior supervisory experience is preferred • Advanced computer skills and abilities in Facets or similar processing systems • Medical terminology • Advanced proficiency in Microsoft Suite to include Word, Excel and Access • Knowledge of regulatory reporting and compliance requirements • Proper medical coding knowledge and claims processing skills.

🏖️ Benefits

• In addition to base compensation, you may qualify for a bonus tied to company and individual performance. • Comprehensive total rewards package.