Benefit Setup Specialist - Remote

 Posted an hour ago
     
2-5 years experience
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AI Summary

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.

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.

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