Plan Building Specialist Remote ONLY MEXICO

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Requirements:

• 2+ years of experience in the healthcare field, claims, or benefits is strongly preferred.
• Experience with self-funded health plans is strongly preferred.
• Strong working knowledge of medical billing and coding and/or medical claims processing.
• High school diploma or general education degree (GED).
• Highly organized, detail-oriented, and deadline-driven.
• Ability to read and interpret various documents.
• Ability to perform basic mathematical operations.
• Ability to apply common sense to carry out instructions.
• Ability to deal with problems involving multiple variables.
• Strong communication skills.

Responsibilities:

• Support Implementation and Account Management teams during new client implementation and renewal to ensure accurate benefits.
• Translate benefits using various insurance billing codes.
• Configure benefits in claims processing systems.
• Generate benefits summaries for internal and external use.
• Ensure compliance with applicable government regulations.
• Audit plan build work of teammates.
• Process group terminations as needed.
• Correspond with various departments.
• Troubleshoot claims errors and escalate issues.
• Support onboarding and training of new team members.