Offer summary

Qualifications:

Proven experience in claims processing and adjudication within healthcare., Familiarity with claims management platforms like Impact and knowledge of DBC coding., Excellent problem-solving and communication skills for collaborative work., Strong critical thinking and organizational skills with attention to detail..

Key responsabilities:

Maintain and enhance the Impact platform through ongoing code updates and system improvements.

Collaborate with internal teams and vendors to implement client-specific integrations.

Provide technical support and guidance to the engineering team on claims processing issues.

Establish best practices in claims adjudication and serve as the primary contact for vendor communications.

Job description

S&S Health is a leading healthcare administration company based in Cincinnati, Ohio, specializing in self, level, and fully funded solutions aimed at lowering costs and improving outcomes while providing a consumer-centric experience. With a nationwide presence, S&S Health delivers comprehensive benefits, services, and technology platforms tailored to meet the unique needs of employers, third-party administrators (TPAs), and health systems.

The Claims Engineer is responsible for maintaining and enhancing our Impact platform, as well as collaborating with internal teams and external vendors to implement integrations. By leveraging expertise in claims processing and adjudication, this role will help establish best practices and contribute to our mission of improving operational efficiency and client satisfaction.

Key Responsibilities:

System Maintenance: Perform ongoing maintenance across the Impact platform, including code updates and system enhancements to ensure optimal performance.
Integration Implementation: Collaborate with internal teams and external vendors to implement necessary integrations tailored to client needs.
Technical Support: Provide technical guidance and support to the engineering team regarding challenges and opportunities related to claims processing.
Best Practices Development: Establish and promote best practices and standards in claims adjudication and system architecture to enhance efficiency and effectiveness.
Vendor Communication: Serve as the primary point of contact for vendors, ensuring effective communication and timely issue resolution.
Collaboration: Work closely with cross-functional teams to facilitate system rebuilds or replacements, ensuring alignment with overall business goals.

Qualifications:

Experience: Proven experience in claims processing and adjudication, with a solid understanding of healthcare claims management.
Technical Proficiency: Familiarity with the Impact system or similar claims management platforms; strong knowledge of DBC coding or similar languages (e.g., Cobalt).
Skills: Excellent problem-solving and communication skills, with the ability to work collaboratively in a fast-paced environment.
Attributes: Strong critical thinking abilities, with exceptional organizational and detail-oriented skills.

S&S Health is committed to providing a safe and secure workplace for all employees. Please note that all final candidates will undergo a comprehensive background check and drug testing as part of our hiring process.

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