Implementation Specialist

🔥 1 hour ago

🏰 Missouri – Remote

🏰 Missouri – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

🛠️ Implementation Specialist

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Healthcare Fraud Shield

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 2011

🏥 Healthcare

💼 Consulting

⚕️ Healthcare Insurance

💰 Private Equity Round on 2021-01

Healthcare • Consulting • Healthcare Insurance

Healthcare Fraud Shield is a company specializing in Payment Integrity and Cost Containment solutions for healthcare insurers. They offer a comprehensive, AI-driven platform that incorporates advanced anomaly detection and a proprietary data fusion library to combat fraud, waste, abuse, and errors in healthcare claims. Their robust end-to-end solution optimizes the auditing process, utilizing both pre- and post-payment data to maximize savings and improve accuracy in claim processing. By providing actionable insights and expert support, Healthcare Fraud Shield helps organizations achieve significant annual savings and enhance operational efficiency.

📋 Description

• Manage assigned implementation tasks to the highest standards. • Apply strong project management and organizational skills to implementation processes. • Utilize analytical and problem-solving skills to identify obstacles and impediments in the client onboarding process. • Perform client data file analysis at various stages throughout the implementation process, assist in documentation related to client data feeds including mapping and special data manipulation needed, and assist in testing for new client implementations. • Ability to work effectively with internal team to discuss and identify resources to efficiently overcome client data obstacles as well as milestone implementation tasks and any special client needs. • Ability to communicate to clients in a professional and timely manner to discuss data needs and concerns, provide status updates, and guide the installation process as needed. • Provide regular status updates to both internal staff and client resources. • Manage project schedules and timelines in project management software and other company project templates. • Always deliver a high level of customer service. • Understands and complies with all company Privacy and Security standards. • Employee may not use or disclose any protected health information, except as otherwise permitted, or required, by law. • Other duties as needed which may include data entry and/or other research tasks.

🎯 Requirements

• Bachelor’s degree required, focus Health Insurance or Administration preferred. • 3+ years’ experience working with Health Insurance claim data or in a related industry preferred. • 1-2 years project management or related experience, preferably supporting efforts to configure and customize a system or product. • Advanced knowledge of Microsoft Office Suite to include Word, Excel, Project, and Outlook. • A good working knowledge of web applications is essential to this role. Experience in healthcare IT, clinical informatics, or Healthcare Fraud, Waste and Abuse (FWA) is strongly desired. • Proven knowledge of health care, insurance, medical terminology, CPT, HCPCS, DRG, Revenue, ICD-9, ICD-10 preferred. • Applicant must be proficient in the use of computers and computer applications. • Proven ability to prioritize and organize large volumes of projects. • Adept at solving problems and making decisions. • Excellent communication skills both verbal and written. • Attentive to detail. • Ability to work in a team environment. • Outstanding organizational and time management skills. • Self-motivated.

🏖️ Benefits

• Medical, Dental & Vision insurance • 401(k) retirement savings with employer match • Vacation and sick paid time off • 7 paid holidays & 2 floating holidays • Paid maternity/paternity leave • Disability & Life insurance • Flexible Spending Account (FSA) • Employee Assistance Program (EAP) • Professional and career development initiatives • Remote work eligible