Plan Setup Specialist

Job Title: Plan Setup Specialist

Location: Hybrid - Mason, OH

Work Hours: 8:00 AM - 5:00 PM

Start Date: September 16, 2024

End Date: December 31, 2024 (Potential extension)

Job Summary:

The Specialist on the Plan Setup Team will be responsible for setting up and maintaining the firm’s managed vision care clients in the core administration system. This role involves setting up new groups, performing audits, and providing support for implementation and client setup processes, while ensuring compliance with corporate and industry audit standards.

Key Responsibilities:

Setup and Maintenance:

• Set up new Managed Care groups in the claims system.
• Make revisions to existing Managed Care groups (except for Reseller product changes).
• Create standard products using the Product Key Sheet method.
• Perform audits on client setup and maintenance requests.

Compliance and Audits:

• Follow corporate and industry audit controls, including SOX and SSAE 18, when fulfilling setup and maintenance requests.

Client Support:

• Resolve setup questions/issues from the team with minimal supervision.
• Maintain relationships with Implementation and Account Managers to ensure timely resolution of questions and requests.

Workflow Management:

• Self-manage workload in the Plan Setup production queues, adhering to established quality and turnaround guidelines.
• Recommend system and process improvements for enhanced performance of the Plan Setup team.

Project Support:

• Assist management with miscellaneous projects and help resolve Plan Setup issues.

Education and Experience Requirements:

Education:

• College degree or equivalent experience required.

Experience:

• Minimum of 1 year of claims system experience, preferably in the healthcare industry.

Skills:

• Basic analytical and problem-solving skills.
• Good communication and interpersonal skills.
• Ability to work independently and collaboratively.
• Strong multitasking skills and ability to manage multiple tasks simultaneously.