Implementation Specialist
4 days ago
Job Title: Implementation Specialist / Case Builder
Location: Remote
Department: Operations
Aboutwe 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 OverviewThis 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 ResponsibilitiesCase 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.
- 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.
- 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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