Plan Configuration Specialist CCH
Community Health System
Job Description
Job Description
Overview
Benefits and Opportunities for you!
- Consecutively recognized as a top employer by Forbes, and in 2025 by Newsweek
- 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.
Responsibilities
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.
Qualifications
Education
- Associate's Degree in Healthcare Administration, Business Administration, Information Systems, or a related field required
- Health insurance or claims administration coursework preferred
- 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
Experience
- 1 year of experience in health plan claims processing, benefits administration, eligibility, plan configuration, or related health insurance operations required
- 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
Licenses and Certifications
- CPC - Certified Professional Coder preferred
Vacancy posted 15 days ago
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