Remote Claims Systems Specialist

Tres Health, Inc.; 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

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