Plan Configuration Specialist CCH
About The Position
The Plan Configuration Specialist is responsible for performing routine benefit plan configuration and maintenance within the Community Care Health (CCH) claims administration system. This position supports testing, validation, and quality review activities to help ensure benefit configurations are accurate and aligned with employer plan documents, regulatory requirements, and internal standards. The Specialist assists with new implementations, annual renewals, plan maintenance, and routine system updates while developing expertise in health plan configuration, claims adjudication, and benefit administration.
Requirements
- Associate's Degree in Healthcare Administration, Business Administration, Information Systems, or a related field required.
- High School Diploma, High School Equivalency (HSE), or Completion of a CHS Approved Individualized Education Plan (IEP) Certificate AND an additional two (2) years of related experience may be substituted in lieu of associate’s degree.
- 1 year of experience in health plan claims processing, benefits administration, eligibility, plan configuration, or related health insurance operations required.
Nice To Haves
- Health insurance or claims administration coursework preferred.
- Experience using QNXT or another healthcare claims administration platform preferred.
- Experience with employer-sponsored health plans preferred.
- Exposure to EDI transactions (837, 835, 270/271) preferred.
- CPC - Certified Professional Coder preferred.
Responsibilities
- Performing routine benefit plan configuration and maintenance within the Community Care Health (CCH) claims administration system.
- Supporting testing, validation, and quality review activities to ensure benefit configurations are accurate and aligned with employer plan documents, regulatory requirements, and internal standards.
- Assisting with new implementations, annual renewals, plan maintenance, and routine system updates.
- Developing expertise in health plan configuration, claims adjudication, and benefit administration.
Benefits
- Free Continuing Education and certification
- Tuition reimbursement, education programs and scholarships
- Vacation time starts building on Day 1, and builds with your seniority
- Free money toward retirement with a 403(b) and matching contributions
- Commitment to diversity and inclusion is a cornerstone of our culture at Community. All are welcome as valued members of our community. We know that our ability to provide the highest level of care is through taking care of our incredible teams.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
