Plan Setup Specialist

Belcan
Mason, OH

Job Title: Plan Setup Specialist Location: MASON, OH Zip Code: 45040 Duration: 5 months Pay Rate: $23.33/hr. Keyword's: #MASONjobs; #SetupSpecialistjobs. Start Date: Immediate Job Description: Job Summary: Provides exceptional service and support to all EyeMed Providers/Locations through execution of provider/location database requests within established performance metrics. Responsible for setting up and maintaining clients in the claims processing system. Additional duties: Supporting the Plan Setup team by assisting with daily administrative duties, including evaluating new requests, coordinating work assignments, running/preparing management reports, performing audits, etc..

MAJOR DUTIES AND RESPONSIBILITIES

  • Responsible for setting up new Managed Care groups in the claims system
  • Responsible for fulfilling requested revisions to existing Managed Care group in the claims system (except Reseller product changes)
  • Responsible for creating 'standard' products in the system (using the Product Key Sheet method)
  • Responsible for performing audits on client setup or maintenance requests (excludes complex product configuration requests)
  • Follow the established corporate and industry audit controls (i.e. SOX, SSAE 18, etc.)
Specific Skills Needed:

***MUST HAVE EXCEL SKILLS***

  • Minimum of 1-3 years experience working in a data entry position
  • Proficient at working on a computer (requirement)
  • Experience using Microsoft Word and Microsoft Excel software (requirement)
  • Ability to work well in a team setting
  • Strong communication and analytical analysis skills required
  • Previous system testing or auditing experience a plus
  • Experience in the Healthcare industry a plus
  • Education: College degree or experience required
There will actually be 5 courses that required for all temporary employees: 3 for Compliance purposes and 2 for HiTrust / Security requirements: 1. General Compliance

2. HIPAA

3. Fraud, Waste, and Abuse 4. Security Essentials 5. Introduction to Phishing In addition; Model of Care, ODAG, FSL Fraud Integral Staff training, CA Fair Claims. Belcan is an equal opportunity employer. Your application and candidacy will not be considered based on race, colour, sex, religion, creed, sexual orientation, gender identity, national origin, disability, genetic information, pregnancy, veteran status or any other characteristic protected by federal, state or local laws.

Posted 2025-09-05

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