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Plan Configuration Specialist CCH

Community Health System
Posted 2 days ago, valid for 18 days
Location

Fresno, CA, US

Salary

$32.71 - $41.62 per hour

Contract type

Full Time

Health Insurance
Tuition Reimbursement

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Overview

Benefits and Opportunities for you! 

  • Consecutively recognized as a top employer by Forbes, and in 2025 by Newsweek 
  • Free Continuing Education and certification  
  • Tuition reimbursement, education programs and scholarships 
  • Vacation time starts building on Day 1, and builds with your seniority 
  • Free money toward retirement with a 403(b) and matching contributions 

Commitment to diversity and inclusion is a cornerstone of our culture at Community. All are welcome as valued members of our community. We know that our ability to provide the highest level of care is through taking care of our incredible teams.

Responsibilities

The Plan Configuration Specialist is responsible for performing routine benefit plan configuration and maintenance within the Community Care Health (CCH) claims administration system. This position supports testing, validation, and quality review activities to help ensure benefit configurations are accurate and aligned with employer plan documents, regulatory requirements, and internal standards. The Specialist assists with new implementations, annual renewals, plan maintenance, and routine system updates while developing expertise in health plan configuration, claims adjudication, and benefit administration.  

Qualifications

Education
  • Associate's Degree in Healthcare Administration, Business Administration, Information Systems, or a related field required
  • Health insurance or claims administration coursework preferred
  • High School Diploma, High School Equivalency (HSE), or Completion of a CHS Approved Individualized Education Plan (IEP) Certificate AND an additional two (2) years of related experience may be substituted in lieu of associate’s degree
 Experience
  • 1 year of experience in health plan claims processing, benefits administration, eligibility, plan configuration, or related health insurance operations required
  • Experience using QNXT or another healthcare claims administration platform preferred
  • Experience with employer-sponsored health plans preferred
  • Exposure to EDI transactions (837, 835, 270/271) preferred
 Licenses and Certifications
  • CPC - Certified Professional Coder preferred

Disclaimers

• Pay ranges listed are an estimate and subject to change.• If any bonuses are noted, they are only applicable to external hires meeting criteria.




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