Benefit Setup Specialist - Remote

Benefit Setup Specialist responsible for interpreting complex health benefits information from written documents and inputting the relevant data into our claims processing system. Essential functions include analysis and configuration of group benefit health plans, demonstrating organized project management, participating in internal and external meetings regarding plan designs and coding, improving system auto adjudication through claims logic coding and plan design, creating/modifying summary of benefits for each new/changed plan, cross-auditing plan documents for benefit accuracy, answering processor questions regarding benefits and plan build, and suggesting improvements in processes. Nonessential functions include other duties as assigned. Ideal candidate will have 2+ years of self-funded health insurance industry experience with experience in benefit programming and knowledge of Trizetto’s Qiclink claims software, strong knowledge of health insurance terminology and coding systems (CPT, ICD-10), excellent attention to detail, effective communication and collaboration skills, and the ability to work in a fast-paced environment and meet tight deadlines. Full benefits are provided. The role is remote with a location in Madison, WI; Equal Opportunity Employer statement included.