Team Lead, Configuration Testing

Sorry, this job was removed Sorry, this job was removed at 09:03 p.m. (CST) on Tuesday, Feb 04, 2025
Be an Early Applicant
Dayton, OH
81K-130K Annually
Healthtech • Insurance
The Role

Job Summary:

The Team Lead, Configuration Testing is responsible for day-to-day activities surrounding the knowledge and insight around testing of medical benefits, provider reimbursement, letters, claims workflow and clinical editing.

Essential Functions:

  • Responsible for day-to-day activities surrounding the knowledge and insight around testing of medical benefits, provider reimbursement, letters, claims workflow and clinical editing
  • Guide and direct successful completion of daily tasks.  Responsible for onboarding, training and development of staff
  • Prioritize all work, requests and activities.  Escalate any area of significant resource contention along with recommendation for resolution
  • Track issues and  status to ensure proper follow-up, coordination  with business area and provide solutions
  • Update project that configuration is involved with and coordinate any needed changes with manager
  • Provide management with ticket dashboards.  Identify root cause of issues and appropriate pro-active resolution  to reduce tickets in the future
  • Ensure ticket controls,  communication and approvals are followed prior to system implementation
  • Maintain and support fee schedules and methodology is consistent with required standards
  • Provide oversight to vendor management tasks conducted by team members.  Ensure timely responses and resolution
  • Assist in auditing system configuration to ensure accuracy and internal controls are in place to minimize potential fraud and abuse and any business issues
  • Perform any other job duties as requested

Education and Experience:

  • Associates Degree or equivalent years of relevant work experience is required
  • Minimum of three (3) years of health plan business or systems solutions experience is required
  • Exposure to Facets or equivalent system is preferred
  • Prior supervisory experience is preferred

Competencies, Knowledge and Skills:

  • Advanced computer skills and abilities in Facets or similar processing systems
  • Medical terminology
  • Advanced proficiency in Microsoft Suite to include Word, Excel and Access
  • High level of programming and systems development knowledge
  • Effective identification of business problems, assessment of proposed solutions to those problems, and understanding of the needs of business partners
  • Demonstrated ability to successfully define a portfolio of initiatives including business requirements gathering, definition/prioritization, project scope definition, project staffing requirements, application configuration, testing approach, training, documentation, reporting strategy,  and change management process
  • Knowledge of regulatory reporting and compliance requirements
  • Excellent listening and critical thinking skills
  • Effective problem solving skills with attention to detail
  • Excellent written and verbal communication skills
  • Ability to work independently and within a team environment
  • Strong interpersonal skills and high level of professionalism
  • Ability to develop, prioritize and accomplish goals
  • Proper medical coding knowledge and claims processing skills

Licensure and Certification:

  • Certified Professional Coder (CPC) is preferred

Working Conditions:

  • General office environment; may be required to sit or stand for extended periods of time

Compensation Range:

$81,400.00 - $130,200.00

CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):

Salary

Organization Level Competencies

  • Create an Inclusive Environment

  • Cultivate Partnerships

  • Develop Self and Others

  • Drive Execution

  • Influence Others

  • Pursue Personal Excellence

  • Understand the Business


 

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an inclusive environment that welcomes and supports individuals of all backgrounds.

Get Personalized Job Insights.
Our AI-powered fit analysis compares your resume with a job listing so you know if your skills & experience align.

The Company
HQ: Dayton, OH
3,668 Employees
On-site Workplace

What We Do

Health Care with Heart. It is more than a tagline; it’s how we do business. CareSource has been providing life-changing health care to people and communities for nearly 30 years and we will continue to be a transformative force in the industry by placing people over profits.

CareSource is and will always be members first. Even as we grow, we remember the reason we are here – to make a difference in our members’ lives by improving their health and well-being. Today, CareSource offers a lifetime of health coverage to nearly 2 million members through plan offerings including Marketplace, Medicare Advantage and Medicaid. With our team of 4,000 employees located across the country, we continue to clear a path to better life for our members. Visit the "Life"​ section to see how we are living our mission in the states we serve.

CareSource is an equal opportunity employer and gives consideration for employment to qualified applicants without regard to race, color, religion, sex, age, national origin, disability, sexual orientation, gender identity, genetic information, protected veteran status or any other characteristic protected by applicable federal, state or local law. If you’d like more information about your EEO rights as an applicant under the law, please click here: https://www.eeoc.gov/employers/upload/poster_screen_reader_optimized.pdf and here: https://www.dol.gov/ofccp/regs/compliance/posters/pdf/OFCCP_EEO_Supplement_Final_JRF_QA_508c.pdf

Si usted o alguien a quien ayuda tienen preguntas sobre CareSource, tiene derecho a recibir esta información y ayuda en su propio idioma sin costo. Para hablar con un intérprete, Por favor, llame al número de Servicios para Afiliados que figura en su tarjeta de identificación.

如果您或者您在帮助的人对 CareSource 存有疑问,您有权 免费获得以您的语言提供的帮助和信息。 如果您需要与一 位翻译交谈,请拨打您的会员 ID 卡上的会员服务电话号码

Similar Jobs

Groundswell Logo Groundswell

Senior Appian Tester (clearable)

Information Technology • Consulting
Remote
49 Locations
360 Employees
73K-152K Annually

Upstart Logo Upstart

Mortgage Mailroom Administrator

Artificial Intelligence • Fintech • Machine Learning • Social Impact • Software
Easy Apply
Remote
Columbus, OH, USA
1500 Employees
53K-53K Annually

Upstart Logo Upstart

Licensed Loan Processor

Artificial Intelligence • Fintech • Machine Learning • Social Impact • Software
Easy Apply
Columbus, OH, USA
1500 Employees
57K-79K Annually

Grainger Logo Grainger

Account Sales Manager

eCommerce • Information Technology • Retail • Industrial
Hybrid
Dayton, OH, USA
26000 Employees
61K-102K Annually

Similar Companies Hiring

MassMutual India Thumbnail
Insurance • Information Technology • Fintech • Financial Services • Big Data
Hyderabad, Telangana
Cencora Thumbnail
Pharmaceutical • Logistics • Healthtech
Conshohocken, PA
46000 Employees
Stepful Thumbnail
Software • Healthtech • Edtech • Artificial Intelligence
New York, New York
60 Employees
By clicking Apply you agree to share your profile information with the hiring company.

Sign up now Access later

Create Free Account

Please log in or sign up to report this job.

Create Free Account