Job detail

Benefit Setup Specialist - Remote

Auxiant

#Project Management #Communication #Collaboration #Health Benefits #Data Analysis #CPT #ICD-10 #Coding #Claims Processing

Quick overview

The Benefit Setup Specialist will be responsible for interpreting complex health benefits information and accurately inputting data into the claims processing system. This includes analyzing and configuring group benefit health plans and improving system auto adjudication through claims logic coding.

Requirements summary

The ideal candidate should have over 2 years of experience in the self-funded health insurance industry, with specific knowledge of Trizetto’s Qiclink claims software. Strong attention to detail and effective communication skills are essential for collaborating with cross-functional teams.

Communication SkillsProject ManagementData AnalysisCollaborationAttention to DetailCPTICD-10Fast-Paced EnvironmentHealth InsuranceClaims ProcessingPlan DesignCoding SystemsBenefit AccuracyClaims Logic CodingBenefit ProgrammingTrizetto Qiclink

Job description

Description https://www.auxiant.com/

Auxiant’s Mission Statement and Core Values

Mission

An Independent TPA investing in People and Innovation to deliver expert-driven experiences with REAL Results.

Core Values

Independent Solutions. REAL Results Respect Empowerment Agility Leadership

Be part of a growing and prospering company as a Benefit Setup Specialist. Auxiant is a third party administrator of self-funded employee benefit plans with offices in Cedar Rapids, IA, Madison and Milwaukee, WI. Auxiant is a fast-growing,progressive company offering an excellent wage and benefit package.

Job Summary

You will be responsible for interpreting complex health benefits information from written documents and accurately inputting the relevant data into our claims processing system.

Essential Functions

Analysis and configuration of group benefit health plans Demonstrate organized and effective project management skills Participate in internal and external meetings regarding plan designs and coding Improve system auto adjudication through claims logic coding and plan design Create/Modify summary of benefits for each new/changed plan Cross-audit plan documents for benefit accuracy Answer processor questions regarding benefits and plan build Suggest improvements in processes

Nonessential Functions

Other duties as assigned or appropriate
Education/Qualifications: Ideal candidate will have 2 plus years of self-funded health insurance industry experience, with experience in benefit programming and specific knowledge of Trizetto’s Qiclink claims software. Strong knowledge of health insurance terminology, coding systems (e.g., CPT, ICD-10), and industry practices. Excellent attention to detail and the ability to interpret complex documents accurately. Effective communication skills and the ability to collaborate with cross-functional teams. Ability to work in a fast-paced environment and meet tight deadlines

Full benefits including

Medical, Dental, Vision, Flexible Spending, Gym Membership Reimbursement, Life Insurance, LTD, STD, 401K, 3 weeks vacation, 9 paid holidays, casual dress code and more We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, disability, marital status, veteran status, sexual orientation, gender identity, or any other protected characteristic.