Configuration Specialist

Job not on LinkedIn

🔥 2 minutes ago

🌪️ Oklahoma – Remote

🌪️ Oklahoma – Remote

💵 $62k - $107k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

👻 Ghost score 2%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Relation Insurance Services

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

💼 Consulting

🏗️ Construction

🏥 Healthcare

Consulting • Construction • Healthcare

Relation Insurance Services is a trusted partner in insurance brokerage, offering personalized solutions across various sectors. The company emphasizes building strong relationships based on trust and understanding client challenges, whether in personal or business contexts. With expertise in industries such as agribusiness, construction, finance, and technology, Relation Insurance Services leverages data-driven insights and long-term carrier relationships to navigate the complexities of insurance, ensuring clients feel safer and more in control of their insurance decisions.

📋 Description

• Configure and maintain health benefit plans within Relation’s Third-Party Administrator claims administration system • Build deductibles, out-of-pocket maximums, copays, coinsurance, benefit limits, exclusions, and other benefit provisions • Configure networks, fee schedules, reimbursement arrangements, benefit codes, system rules, and related plan components • Maintain plan configurations for renewals, amendments, and effective-date changes • Review plan documents and supporting materials for missing, conflicting, or unclear benefit information • Validate configured benefits against approved plan documents and client requirements • Develop and execute claim test scenarios to verify benefit calculations and claims processing • Research and resolve configuration discrepancies identified during testing or claims processing • Coordinate quality assurance and testing activities before implementation or release • Coordinate plan setup and processing questions with Claims, Eligibility, Client Services, and other internal teams • Document configuration changes, source materials, and testing results • Identify recurring configuration issues, root causes, and process improvement opportunities • Use technology, automation tools, and Relation’s proprietary AI-enabled solutions to improve configuration accuracy, testing, documentation, and workflow efficiency while protecting confidential information • Perform other assigned projects, duties, and tasks

🎯 Requirements

• High school diploma or equivalent required • Two years of experience in health benefit administration, medical claims processing, plan configuration, or a related healthcare benefits function • Experience configuring health benefit plans within a third-party administrator (TPA), self-funded health plan, payer or health plan environment preferred • Familiarity with healthcare coding, HIPAA-related claims standards, or other system rules used in medical claims adjudication preferred • Knowledge of health plan benefit structures, including deductibles, out-of-pocket maximums, copays, coinsurance, limits, and exclusions • Ability to interpret plan documents, benefit summaries, and client requirements and translate the information into accurate system configurations • Ability to develop and execute benefit configuration testing and analyze claim processing results • Strong analytical and problem-solving skills and attention to detail • Ability to identify and resolve configuration discrepancies • Ability to document configuration changes, testing results, and issue resolution clearly and consistently • Proficiency in Microsoft Office • Ability to learn and effectively use claims administration, benefit configuration, and related business systems • Ability to manage multiple priorities and communicate effectively with operational and technical partners

🏖️ Benefits

• Competitive pay • Family health and wellness programs • 401K • Employee assistance programs • Paid time off • Paid holidays • Career advancement and development opportunities • Discretionary annual incentive program eligibility, subject to program rules and individual and organizational performance