The Plan Building Analyst is responsible for coding and maintaining group benefit plans within the Qiclink system while ensuring accuracy through audits. They also coordinate with account management and claims teams to resolve benefit-related issues and support system upgrades.
The Case Manager will evaluate clinical and claims information to develop and implement strategic care plans for members. They act as a liaison between clients, vendors, and internal departments to ensure optimal health outcomes and cost savings.
The Revenue Analyst supports strategic and financial objectives by analyzing claims data for prospective and current client health plans. They also assist in pricing proposals, stop loss coverage placement, and managing relationships with vendor partners.
The HR Business Partner serves as a strategic advisor to business leaders, aligning talent strategy with organizational goals to drive growth and effectiveness. This role involves managing workforce planning, performance management, employee relations, and fostering a positive company culture.
The GRC Analyst supports the development and maintenance of security controls while ensuring regulatory compliance across the organization. They are responsible for conducting risk assessments, managing vendor due diligence, and facilitating internal and external audits.
The Billing Coordinator manages the end-to-end group medical premium billing cycle, including account setup, invoice generation, and validation of billing outputs. They collaborate with internal teams to resolve billing discrepancies and ensure alignment with quoted rates and system configurations.
The Treasury Services Specialist acts as a subject matter expert for daily treasury processes, including monthly reconciliations and business banking setup. The role also involves building new processes, providing team training, and supporting vendor maintenance and payment implementation.
The Senior Refund Analyst is responsible for logging, tracking, and processing all refunds received on claims. They also coordinate with department personnel to determine refund appropriateness and generate monthly reports on processing errors.
The Senior RRT Analyst manages incoming referrals, distributes team assignments, and oversees Blue Cross Blue Shield and Anthem adjustment processes. They are also responsible for running special project reports, providing team training, and maintaining departmental workflows.
The Project Manager, Operations is responsible for managing the implementation of operational projects, new products, and services through the PMO delivery framework. They will collaborate with cross-functional teams to plan, execute, and deliver projects while ensuring alignment with governance and reporting standards.
The Supervisor, Stop Loss assists in overseeing department operations, including auditing claim filings, tracking reimbursements, and managing cash advance claims. They are also responsible for leading, coaching, and developing staff through performance appraisals and training initiatives.
The Senior Transplant Coordinator manages high-level internal and external relationships, oversees organ transplant claims, and handles department escalations. They also provide strategic insights, mentor staff, and ensure accurate documentation of complex systems and workflows.
The Case Manager will evaluate clinical and claims information to develop and implement strategic care plans for members. They act as a liaison between members, vendors, and internal departments to ensure effective case management and cost-saving outcomes.
The Repricing Coordinator is responsible for re-pricing medical and dental claims using multiple applications to obtain discounted rates. They must also key claims into the QicLink system while maintaining high accuracy standards.
The Software Engineer I is responsible for maintaining and developing software applications while contributing to the application development process through coding, debugging, and testing. They will work in an agile environment to design, release software enhancements, and collaborate with QA to build automation tests.
The Reporting Specialist manages data entry, auditing, and reporting workflows within the company's CRM and executive reporting systems. They also collaborate with internal teams to support client retention and ensure the accuracy of stop loss contract data.
The Project Leader is responsible for managing the implementation of new projects within the Claims Distribution and Repricing Department. They will analyze current workflows and systems to provide recommendations for process improvements and act as the primary point of contact for stakeholders.
The Eligibility Specialist manages the setup and daily operations of eligibility technology platforms, including data transfers and EDI processing. They are responsible for configuring group setups, conducting quality assurance testing, and providing technical support to clients.
The Appeals Specialist organizes and completes all claim appeals by reviewing supporting documentation and Summary Plan Documents. They are responsible for composing response letters, documenting outcomes in the QicLink system, and communicating with clients and other departments.
The Associate Client Executive manages and nurtures client relationships to drive retention and growth within a specific portfolio. Key duties include managing renewal processes, conducting open enrollment presentations, and resolving routine billing or underwriting issues.
The analyst is responsible for the administration, configuration, and continuous improvement of the company's business application portfolio. This includes partnering with stakeholders and vendors to design workflows, manage system access, and provide day-to-day technical support.
The Billing Specialist I will assist in file imports, state reporting, client invoicing, and maintaining reports. They will also follow up on payments, resolve discrepancies, and collaborate with other departments for accurate billing.
Manage a book of self-funded group health plans, serving as the primary liaison between clients, brokers, and internal departments. Responsibilities include overseeing new business implementation, conducting plan performance reviews, and ensuring overall client satisfaction.
The Case Management Liaison manages internal and external relationships and handles department escalations. They are responsible for documenting processes, providing training to staff and vendors, and collaborating with stakeholders to improve workflows.
Manage a book of self-funded group health plans, serving as the primary resource for clients and brokers. Responsibilities include reviewing plan performance, ensuring ACA compliance, and conducting client presentations to ensure retention.
Facilitate the implementation of new products, services, and compliance initiatives while managing vendor relationships. Develop project plans, track milestones, and collaborate with cross-functional teams to ensure seamless execution.
The Data Analyst manages inbound and outbound EDI projects, specifically focusing on ANSI X12-834 eligibility files and custom data extracts. They are responsible for configuring, testing, and monitoring data integrations while resolving discrepancies between internal teams and external partners.
The Client Executive is responsible for driving new business growth by cultivating relationships with brokers and consultants. They manage complex negotiations, execute sales strategies, and handle the renewal process for their assigned book of business.
The Client Service Representative acts as the primary point of contact for members, brokers, and HR representatives to resolve inquiries and issues. They liaise between clients and internal departments to manage claim resolutions, reporting, and the renewal of existing cases.
This role is responsible for driving the internal execution of Artificial Intelligence initiatives, focusing on deploying Generative AI, predictive modeling, and intelligent automation across real business workflows. The Product Owner will define product requirements, manage AI roadmaps, and coordinate delivery across engineering, data science, and business teams to solve problems at scale.
