Health Plan Configuration Auditor — Remote

Healthez Inc; Minneapolis (MN); Remote; USD 75,000 - 95,000; Full time

Benefits offered by this job

Health benefits

401k plan

Paid time off

Parental leave

Job summary

HealthEZ is seeking a Plan Build Auditor to review and validate health plan configurations, ensuring accuracy and consistency with approved requirements and plan documents. You will act as a subject matter expert in plan configuration and claims adjudication, providing independent assessments prior to implementation.

Remote work is available 100%. You will collaborate with Plan Builders, Operations, and Leadership to drive quality, testing, and continuous improvement while supporting complex

Qualifications

• Minimum of five years in health plan configuration, claims admin, or related healthcare Ops.
• Experience interpreting plan documents and translating requirements into system configuration.
• Knowledge of benefit plan design, claim adjudication, and configuration methodology.
• Familiarity with plan documents, accumulators, cost-share structures, and claim processing logic.

Responsibilities

• Audit and validate plan configurations for alignment with requirements and plan docs.
• Review configuration outcomes through testing and adjudication review.
• Document findings, communicate recommendations, and track resolutions.
• Support implementation activities for clients and system enhancements.
• Promote adherence to configuration standards and quality controls.
• Participate in departmental initiatives and special projects as assigned.

Skills

Analytical skills

Problem-solving

Written communication

Verbal communication

Attention to detail

Organizational skills

Excel

Education

Bachelor's or Associate degree in Business / Healthcare Administration / Information Systems

Tools

VBA

Microsoft Excel

Job description

HealthEZ is seeking a Plan Build Auditor to review and validate health plan configurations, ensuring accuracy and consistency with approved requirements and plan documents. You will act as a subject matter expert in plan configuration and claims adjudication, providing independent assessments prior to implementation.

Remote work is available 100%. You will collaborate with Plan Builders, Operations, and Leadership to drive quality, testing, and continuous improvement while supporting complex