Business Systems Specialist

Tres Health; United States; Remote; USD 75,000 - 110,000; Full time

Job summary

Tres Health, Inc. is seeking a Business System Specialist to configure enterprise applications and support claims data flows.

You will work with the TPA Operations teams, Implementation and Renewal teams to configure groups within the claims system, test onboarding with external vendors, and troubleshoot day-to-day data feed and system issues affecting members and employers. The ideal candidate is organized, self-motivated, and proficient in claims administration systems and EDI, with strong

Qualifications

• 3-5 years of experience configuring enterprise applications.
• Experience with claims administration systems and EDI.
• Strong troubleshooting and problem-solving skills.
• Experience with testing and documentation.
• Excellent verbal and written communication.
• Ability to manage multiple priorities in a fast-paced environment.
• Information security awareness: understanding of PII, PHI, and HIPAA compliance.

Responsibilities

• Configure and QA claims system to support new group and renewal onboarding.
• Assist with external vendor onboarding and project initiatives with system testing, validation, and quality assurance.
• Troubleshoot and resolve technical or configuration issues for internal teams and coordinate with vendors when necessary.
• Support software implementations, upgrades, and system migrations.
• Assist with data validation, imports, exports, and system integrations.
• Ensure compliance with organizational security, governance, and audit requirements.
• Other tasks as assigned.

Skills

Enterprise app config

Troubleshooting

Documentation

Communication skills

Multitasking

HIPAA awareness

Tools

EDI

API integrations

Job description

The Business System Specialist is responsible for configuring the systems used to maintain business and operational requirements. This role also provides technical support to internal teams presenting technical issues related (but not limited) to claims, file feeds, and eligibility.

This role works closely with the TPA Operations teams, Implementation and Renewal teams, developers, and project management to configure groups within the claims system, support testing for external vendor onboarding and project initiatives, and troubleshoot day-to-day issues related to data feeds and system functionality affecting members, employers, and external vendors. The ideal candidate is highly organized, self-motivated, and possesses strong problem-solving skills. This individual demonstrates a strong sense of urgency, excels in a fast-paced environment, and has (some) experience with claims administration systems, and electronic data interchange (EDI).

• Configure and QA claims system to support new group and renewal onboarding.
• Assist with external vendor onboarding and project initiatives with system testing, validation, and quality assurance.
• Troubleshoot and resolve technical or configuration issues for internal teams and coordinate with vendors when necessary.
• Support software implementations, upgrades, and system migrations.
• Assist with data validation, imports, exports, and system integrations.
• Ensure compliance with organizational security, governance, and audit requirements.
• Other tasks as assigned.

Minimum Qualifications

• 3-5 years of experience configuring enterprise applications or business systems.
• Experience with claims administration systems, and electronic data interchange (EDI).
• Strong troubleshooting, and problem-solving skills.
• Experience with system testing, and documentation.
• Excellent verbal and written communication skills.
• Ability to manage multiple priorities in a fast-paced environment.
• Information security awareness: Understanding of PII, PHI, and HIPAA compliance.

Preferred Qualifications

• Experience with claims administration systems, and electronic data interchange (EDI).
• Experience working with or within a Third-Party Administrator (TPA).
• Experience in API integrations is a plus.

Work Schedule & Remote Work

Full-time, remote position aligned with U.S. business hours. Flexibility required for critical project deadlines, cross-functional meetings, and occasional travel (0-10%) for team collaboration or vendor engagements.

Remote Work Requirements

• Dedicated home office with reliable, high-speed internet.
• Secure workspace aligned with HIPAA security standards (device encryption, secure Wi-Fi, screen privacy).
• Ability to effectively coordinate and lead projects in a fully remote environment.

Security, Privacy & Compliance

This position requires adherence to Tres Health’s security and privacy policies, including HIPAA compliance. All employees must complete security training and comply with access management protocols.

Physical Requirements

• Prolonged periods of sitting and working at a computer.
• Ability to communicate effectively through video, phone, and written platforms.
• Ability to effectively use computers, video conferencing tools, and other standard remote work technology.
• Ability to occasionally lift up to 15 pounds.
• Tres Health is committed to ADA compliance and will provide reasonable accommodations to individuals as needed.

Employment Status

This position is governed by at-will employment, meaning either the employee or Tres Health may end the employment relationship at any time, with or without cause or notice, as permitted by law.

EEO & Reasonable Accommodation

Tres Health is an Equal Opportunity Employer. Qualified applicants will receive consideration without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other protected category. Tres Health provides reasonable accommodations to enable individuals with disabilities to perform the essential functions of the role. This description is not intended to list all duties or qualifications and may be updated at any time.