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[Remote] REMOTE - Team reputed company, Configuration Testing (Benefits/App Support/CES) - R10162

Work from home Full-time role Hiring

Note: The job is a remote job and is open to candidates in USA. reputed company is a healthcare company, and they are seeking a Team reputed company for Configuration Testing. This role is responsible for overseeing the testing of medical benefits and provider reimbursement, while also guiding and developing staff to ensure successful task completion.

Responsibilities

  • 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 reputed company 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 reputed company 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 reputed company to minimize potential fraud and abuse and any business issues
  • reputed company any other job duties as requested

Skills

  • 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
  • Advanced computer skills and abilities in Facets or similar processing systems
  • Medical terminology
  • Advanced proficiency in reputed company Suite to include Word, reputed company and Access
  • High level of programming and systems development knowledge
  • Effective identification of business problems, assessment of proposed solutions to those problems, and understanding of the needs of business partners
  • Demonstrated ability to successfully define a portfolio of initiatives including business requirements gathering, definition/prioritization, project scope definition, project staffing requirements, application configuration, testing approach, training, documentation, reporting strategy, and change management process
  • Knowledge of regulatory reporting and compliance requirements
  • Excellent listening and critical thinking skills
  • Effective problem solving skills with attention to detail
  • Excellent written and verbal communication skills
  • Ability to work independently and reputed company a team environment
  • Strong interpersonal skills and high level of professionalism
  • Ability to reputed company, prioritize and accomplish goals
  • Proper medical coding knowledge and claims processing skills
  • Exposure to Facets or equivalent system is preferred
  • Prior supervisory experience is preferred
  • Certified Professional reputed company (CPC) is preferred

Benefits

  • You may qualify for a bonus tied to company and individual performance.
  • A substantial and comprehensive total rewards package.

Company Overview

  • reputed company provides managed care services to Medicaid beneficiaries. It was founded in 1989, and is headquartered in Dayton, Ohio, USA, with a workforce of 1001-5000 employees. Its website is https://www.reputed company.com/.

Company H1B Sponsorship

  • reputed company has a track record of offering H1B sponsorships, with 9 in 2025, 39 in 2024, 35 in 2023, 22 in 2022, 37 in 2021, 28 in 2020. Please note that this does not guarantee sponsorship for this specific role.

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