The Role
Manage client onboarding and implementations: oversee timelines, analyze and map client claim data, test integrations, communicate status to clients and internal teams, and ensure documentation and privacy compliance.
Summary Generated by Built In
As an Implementation Specialist, you will play a key role in the planning and implementation of new client installations including project timeline management, data analysis, ensuring documentation meet organizational standards, handling client outreach and communication, and monitoring and communicating project deliverable deadlines.
Key Responsibilities
- Manage assigned implementation tasks to the highest standards.
- Apply strong project management and organizational skills to implementation processes.
- Utilize analytical and problem-solving skills to identify obstacles and impediments in the client onboarding process.
- Perform client data file analysis at various stages throughout the implementation process, assist in documentation related to client data feeds including mapping and special data manipulation needed, and assist in testing for new client implementations.
- Ability to work effectively with internal team to discuss and identify resources to efficiently overcome client data obstacles as well as milestone implementation tasks and any special client needs.
- Ability to communicate to clients in a professional and timely manner to discuss data needs and concerns, provide status updates, and guide the installation process as needed.
- Provide regular status updates to both internal staff and client resources.
- Manage project schedules and timelines in project management software and other company project templates.
- Always deliver a high level of customer service.
- Understands and complies with all company Privacy and Security standards.
- Employee may not use or disclose any protected health information, except as otherwise permitted, or required, by law.
- Other duties as needed which may include data entry and/or other research tasks.
Skills, Knowledge and Expertise
Qualifications:
- Bachelor’s degree required, focus Health Insurance or Administration preferred.
- 3+ years’ experience working with Health Insurance claim data or in a related industry preferred.
- 1-2 years project management or related experience, preferably supporting efforts to configure and customize a system or product.
- Advanced knowledge of Microsoft Office Suite to include Word, Excel, Project, and Outlook.
Skills:
- A good working knowledge of web applications is essential to this role. Experience in healthcare IT, clinical informatics, or Healthcare Fraud, Waste and Abuse (FWA) is strongly desired.
- Proven knowledge of health care, insurance, medical terminology, CPT, HCPCS, DRG, Revenue, ICD-9, ICD-10 preferred.
- Applicant must be proficient in the use of computers and computer applications.
- Proven ability to prioritize and organize large volumes of projects.
- Adept at solving problems and making decisions.
- Excellent communication skills both verbal and written.
- Attentive to detail.
- Ability to work in a team environment.
- Outstanding organizational and time management skills.
- Self-motivated.
Benefits
- Medical, Dental & Vision insurance
- 401(k) retirement savings with employer match
- Vacation and sick paid time off
- 7 paid holidays & 2 floating holidays
- Paid maternity/paternity leave
- Disability & Life insurance
- Flexible Spending Account (FSA)
- Employee Assistance Program (EAP)
- Professional and career development initiatives
- Remote work eligible
REMOTE WORK REQUIREMENTS:
- Must have high speed Internet (satellite is not allowed for this role) with a minimum speed of 25mbs download and 5mbs upload.
Healthcare Fraud Shield is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
About
Healthcare Fraud Shield, headquartered in Chesterfield, MO, is a leading provider of innovative fraud, waste, and abuse (FWA) solutions for healthcare insurance payers. Since its establishment in 2011, the company has focused solely on healthcare fraud prevention and payment integrity, delivering unique advantages to its broad client base. At the heart of Healthcare Fraud Shield's offerings is FWAShield™, an integrated platform designed by industry-leading healthcare experts. This comprehensive solution includes PreShield™ (pre-payment), PostShield™ (post-payment), RxShield™ (pharmacy analytics), CaseShield™ (case management), and QueryShield™ (ad-hoc querying tool). Leveraging the latest technology available, Healthcare Fraud Shield provides the most affordable, flexible, transparent, efficient, and effective solution in the marketplace. With over 20 years of experience, the founders of Healthcare Fraud Shield are pioneers in successful fraud detection software development in the financial services industry. They have designed their suite of software to identify superior FWA rates, utilizing advanced analytics, AI, and the best exterior data. Additionally, Healthcare Fraud Shield offers expert services in detecting and verifying suspected FWA billed services, including the development of claim edit rules. Their experienced SIU team, which includes Accredited Health Care Fraud Investigators and Certified Professional Coders, delivers top-notch training throughout the country. Trust Healthcare Fraud Shield to safeguard your healthcare insurance payments and ensure payment integrity.
Skills Required
- Bachelor's degree
- 1-2 years project management or related experience configuring/customizing systems
- Advanced knowledge of Microsoft Office (Word, Excel, Project, Outlook)
- Working knowledge of web applications
- Proficiency with computers and computer applications
- High-speed Internet (minimum 25 Mbps down / 5 Mbps up; no satellite)
- 3+ years working with health insurance claim data (preferred)
- Experience in healthcare IT, clinical informatics, or Healthcare Fraud, Waste and Abuse (preferred)
- Knowledge of medical coding/terminology (CPT, HCPCS, DRG, ICD-9, ICD-10)
- Excellent verbal and written communication skills
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The Company
What We Do
Healthcare Fraud Shield provides AI-powered SaaS solutions and dynamic software to detect and prevent healthcare fraud, waste, abuse, and error (FWAE) across the claims lifecycle.
