Configuration Specialist
$70,000–$95,000 year
RemoteUnited States
Job Summary
Review and translate business requirements into configurable components, then design solutions that drive automated and accurate outcomes. Develop, maintain, and execute configuration changes for benefits, pricing, member products, premium billing, and workflow rules while coordinating with third-party software. Work with testers, operations, and clients to ensure results match requirements, continuously validate the configuration environment, and document all changes. Provide support in troubleshooting issues, track progress of completion, and deploy changes within expected timelines. Requires 2-6 years in the healthcare payer segment, strong SQL and Excel skills, and knowledge of Medicare and Medicaid rules.
Required Qualifications
- 2-6 years in healthcare industry experience working in the payer segment in Medicare Advantage, Managed Medicaid, or working with other healthcare service providers
- Experience in setting up and maintaining healthcare payor system configuration
- knowledge of Medicare rules and the ability to translate into business outcomes
- Strong SQL experience
- MS Excel
- MS Access
- Exceptional interpersonal, listening, written and oral communication abilities
- Attention to detail
- the ability to work under time constraints
Desired Qualifications
- Experience in commercial lines of business
- A bachelor's degree or equivalent
- Experience with Healthcare EDI files
- knowledge of Medicaid rules
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