Healthcare Specialist Jobs

Hello, looking for an 100 percent remote- strong Healthcare Specialist that comes from an healthcare background! If you have healthcare experience, claims experience, or insurance experience you would be great for this, in addition to having strong excel experience. This opportunity starts on July 10th and for the first 5 weeks is a strict attendance policy- no time can be taken off during that time. After that hours are flexible as long as you work 8 hours per day!!

**You do have to take an excel assignment and have to get above an 80 percent on it to move on to interview status**

PAY RATE: 20.50- NO ROOM for flexibility- this is the set rate!

6 month contract with EXTENSIONS- could convert perm - based on performance

Healthcare Specialist– July 10th start date .

This is one of our top health care clients, is seeking a talented professional to join their PBM Ops vertical as an Account Install Specialist, Quality Assurance Specialist, or Network Pricing Specialist, to assist with the upcoming Peak Season. Within PBM Ops, the overall goal is to ensure that their system, RxClaim, is up-to-date and accurate so that insurance claims process through correctly and the member is paying what they should, and the insurance company is paying what they should.

Education & Skills Needed:

- Bachelor's degree or associate degree OR 2 or more years of applicable professional experience

- Intermediate to advanced Excel skills -- specifically, sorting and filtering

- Technical aptitude; ability to learn new technologies and processes quickly

- Affinity for data; enjoy working within a data-intensive environment

- Strong attention to detail

- Strong team player

Plusses

- AS400 system experience

- PBM experience

- Health care experience

- Insurance experience

- Claims experience

Day-to-Day

An employer is looking for a highly-skilled Healthcare Benefit Analyst / Account Install Specialist (AIS) to join one of our largest national healthcare clients for a remote opportunity. As an AIS, you will be responsible for building and coding the new benefit plan designs into the corporations claims processing system, RxClaim. Blue Cross Blue Shield (their client) sends information about their new or updated pharmacy benefit plans they offer to members, and you take this information to code and input it into RxClaim so that their system can process claims correctly. You will also implement benefit plan changes or updates. RxClaim is a computer program that prompts you through each step, and you will run through the system and code in the benefit plan information as you go. You do not need to have previous experience with RxClaim in order to be successful on this team. Additionally, you will be tasked with performing root-cause analysis for incoming inquiries regarding benefit coding or claims processing.

You will also be responsible for the following: system testing, supporting/monitoring system capabilities, providing Benefit Edit Tool (BET) submission support to clients, and general tasks related to the assurance of correct claims processing. You will also use Excel for plan build checklists and macros. The macros are created by IT, so you wont create macros, but you will learn to use them. Macros are used to add drug lists to the benefit plans in one large step instead of entering everything in individually for each plan. You will also run reports and queries to perform analysis on the plans you build. This is a collaborative and team-oriented environment, so you will also communicate and interact with other team members and departments. This is a contract opportunity with potential of conversion or extension based on performance. About the Company: Our current employees love it here! This is a growing healthcare company located in the Twin Cities are with huge potential for upward mobilit! y and growth. The culture is second to none and they have a pervasive "work hard, play hard" mentality. They have a robust training and development program that lasts your first 5 weeks on the job. Additionally, the company strives to promote from within whenever available. It is important to note that this is a corporate healthcare setting and you will be working at a desk. Hours: The company's core hours are 9:00 AM-3:00 PM, so there is flexibility with start and end time as long as you work 8 hours daily, and start work no later than 9 am, and leave work no earlier than 3 pm each day. These hours will go into effect after the training period.

Training Hours: 8:00-5:00 PM, Monday-Friday for the first 5 weeks.