Our client is looking for SYSTEM ANALYST/ADMINISTRATOR located in Metro Detroit
The company is seeking a highly motivated Systems Administrator to support their Benefit Administration unit. This position will play a critical role in supporting claims processing systems, EDI functions, vendor coordination, and overall system administration within a healthcare benefits environment.
ESSENTIAL DUTIES & RESPONSIBILITIES
Daily uploading and monitoring of Claims, Referrals, and Prior Authorization files.
Process disability checks and positive pay files.
Perform EOB and check validation activities including corrections and troubleshooting.
Work closely with external vendors and claims system partners to resolve technical and processing issues.
Assign and coordinate tickets between internal departments and claims system vendors.
Establish and maintain system access, security controls, rules, and roles across external systems.
Monitor and validate incoming and outgoing EDI files.
Maintain Benefit Schedules, B-Codes, B-Code groups, Medical Carrier Message Codes, and quarterly procedure/diagnosis code updates within vendor systems.
Add, update, and maintain system integrity and security configurations.
Troubleshoot claims processing errors in collaboration with the Claims Manager.
Assist with policy and procedure updates and documentation.
Support ongoing healthcare claims processing operations and systems administration functions.
EDUCATION & EXPERIENCE:
Bachelor s degree in Information Technology or related field preferred.
3 5 years of Systems Administration experience required.
At least 3 years of healthcare benefits administration and/or claims processing experience preferred.
Experience supporting claims systems, EDI processing, and vendor management strongly preferred.
Strong troubleshooting, systems support, and security administration experience desired.
If you are a high performer and would like to work for an equally high performing company and you think the above opportunity is appropriate for you, we invite you to apply to this job and email your resume to aparish@venteon.com.
We treat all resumes with strict confidentiality. We will always contact you first before submitting your resume to our client(s) for review. If you do not receive correspondence, you are not a fit for this position.
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