Implementation Specialist

4 days ago

Work from Home, Philippines Spoke Full time ₱350,000 - ₱700,000 per year

Job Title: Implementation Specialist / Case Builder

Location: Remote

Department: Operations

About

we are transforming the healthcare landscape by providing innovative, cost-effective solutions in the insurance industry. As we continue to expand, we are seeking a dedicated Implementation Specialist / Case Builder to support the seamless onboarding and configuration of new employer groups and plans.

Position Overview

This remote role is ideal for a highly organized professional with experience in health insurance plan setup and administration. The Implementation Specialist will be responsible for configuring employer-sponsored health plans, ensuring data accuracy, and supporting the implementation of new clients. This position requires strong attention to detail, experience with benefits administration platforms, and a collaborative approach to working with internal and external stakeholders.

Key Responsibilities

Case Setup & Configuration

  • Configure employer group benefits, including MEC, MVP, level-funded, and self-funded plans.
  • Input plan details, rates, eligibility rules, and carrier requirements into the system.
  • Ensure all case builds meet compliance, regulatory, and business requirements.

Implementation & Onboarding

  • Support the implementation process for new clients and renewals from beginning to end.
  • Work with brokers, TPAs, underwriters, and internal teams to validate plan setup.
  • Conduct data audits to ensure system accuracy and troubleshoot discrepancies.

Data Management & System Integration

  • Load and validate enrollment data and eligibility files.
  • Collaborate with IT and development teams for API integrations with carriers and vendors.
  • Maintain documentation for system configurations and implementation processes.

Client Support & Troubleshooting

  • Serve as a key point of contact for implementation-related inquiries.
  • Provide ongoing support for case modifications, corrections, and updates.
  • Identify process improvements to enhance implementation efficiency.
Qualifications & Experience
  • 2+ years of experience in benefits administration, health insurance implementation, or case building.
  • Strong understanding of group health insurance products, including MEC, MVP, level-funded, and self-funded plans.
  • Experience working with benefits administration platforms (e.g., EDI systems, TPA software, or enrollment platforms).
  • Proficiency in handling enrollment data, eligibility files, and carrier integrations.
  • Excellent attention to detail, problem-solving skills, and ability to manage multiple tasks in a fast-paced environment.
  • Strong communication and collaboration skills to work effectively with internal teams and external partners.
  • Experience with API integrations and data mapping (preferred).
  • Familiarity with compliance regulations (ACA, HIPAA, etc.) is a plus.
What We Offer
  • Fully remote position with flexible working hours.
  • Competitive salary and benefits package.
  • Opportunity to be part of a growing and innovative health insurance company.
  • Professional development and career growth opportunities.

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