Provider Data & Claims Configuration Specialist

WelbeHealth, LLC.; Los Angeles (CA); On-site; USD 70,000 - 74,000; Full time

Benefits offered by this job

Medical insurance (Medical, Dental, &

PTO, holidays, and sick days

401K savings + match

Bonus eligibility

Job summary

WelbeHealth, LLC. is seeking a Configuration Coordinator to manage provider network data in our claims processing system and ensure accurate, timely claims processing.

The role reports to the Configuration Manager and supports our mission to care for vulnerable seniors. Responsibilities include building and auditing provider data, resolving EDI failed claims, validating W9 forms, and configuring out-of-network rates.

Qualifications

• High school diploma or equivalent required; Associate degree preferred.
• Minimum of three years of experience in healthcare claim system configuration.
• Experience maintaining provider network data in electronic claims processing systems.
• Exceptional interpersonal skills and ability to collaborate.
• Ability to manage multiple projects with high attention to detail.
• Willing to work evenings, nights, weekends, and overtime.

Responsibilities

• Build, maintain, test, and audit provider network data in our claims processing system to ensure accurate claims processing.
• Monitor, research, and resolve EDI (837D, 837I, 837P) failed claims queues promptly.
• Validate and process W9 provider tax forms.
• Configure standard rates for out-of-network organizations within the system.

Skills

Healthcare claims config

Provider network data

EDI troubleshooting

Interpersonal skills

Time management

Education

High school diploma or equivalent

Associate’s degree preferred

Tools

EDI system

Job description

WelbeHealth, LLC. is seeking a Configuration Coordinator to manage provider network data in our claims processing system and ensure accurate, timely claims processing.

The role reports to the Configuration Manager and supports our mission to care for vulnerable seniors. Responsibilities include building and auditing provider data, resolving EDI failed claims, validating W9 forms, and configuring out-of-network rates.