Remote Claims Systems Specialist (EDI & Onboarding)

Tres Health, Inc.; United States; Remote; USD 80,000 - 100,000; Full time

Job summary

Tres Health, Inc. is seeking a Business System Specialist who configures enterprise systems to meet business and operational needs and provides internal technical support related to claims, file feeds, and eligibility.

You will collaborate with TPA Operations, Implementation and Renewal teams, developers, and project management to configure systems, test onboarding with external vendors, troubleshoot data feeds, and ensure security and HIPAA compliance in a fast-paced, fully remote environment.

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.

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

Configuring enterprise apps

EDI experience

Troubleshooting

Documentation

Verbal & written communication

Multi-priority management

Job description

Tres Health, Inc. is seeking a Business System Specialist who configures enterprise systems to meet business and operational needs and provides internal technical support related to claims, file feeds, and eligibility.

You will collaborate with TPA Operations, Implementation and Renewal teams, developers, and project management to configure systems, test onboarding with external vendors, troubleshoot data feeds, and ensure security and HIPAA compliance in a fast-paced, fully remote environment.