Expired: over a month ago. Applications are no longer accepted.
1. Analyze standard and customized coding requests and work with internal teams to obtain the accurate and complete plan documentation needed to code client intent into the OneArk system.2. Implement new and maintain existing benefit plans, pricing, and networks in the OneArk system, consistent with the direction and intent set forth by the client.3. Maintain the formularies and clinical program offerings in the OneArk system.4. Work collaboratively with the Quality Specialist to perform pre- and post-implementation claim testing and other configuration quality reviews to ensure accurate claim adjudication and adherence to standard and custom design requirements.5. Identify discrepancies, inaccuracies and unintended consequences, and take corrective action.6. Research and respond to claims processing and system configuration inquiries from internal departments.7. Proactively identify setup service issues and escalate to the Client Service Specialist II, Client Service Supervisor or Manager for immediate review and resolution.8. Accurately configure non-adjudicated services and fees across multiple systems.9. Complete department or corporate projects as assigned.10. Perform other duties as assigned.11. Conducts internal cross training to other associates, client training and educations or other services available, when required. AppleOne is proud to be an Equal Opportunity Employer. Pursuant to applicable state and municipal Fair Chance Laws and Ordinances, we will consider for employment qualified applicants with arrest and conviction records.