Claims Systems Engineer - REMOTE

Job Description

S&S Health is a leading healthcare administration company based in Cincinnati, Ohio, specializing in self, level, and fully funded solutions aimed at lowering costs and improving outcomes while providing a consumer-centric experience. With a nationwide presence, S&S Health delivers comprehensive benefits, services, and technology platforms tailored to meet the unique needs of employers, third-party administrators (TPAs), and health systems.

The Claims Systems Engineer is responsible for maintaining and enhancing the technical aspects of our claims platform (Impact). This individual will collaborate with internal development teams and external partners to implement system integrations, automate workflows, and drive the scalability and efficiency of our claims adjudication ecosystem.

Key Responsibilities:

System Maintenance: Perform ongoing maintenance across the Impact platform, including code updates and system enhancements to ensure optimal performance.

Integration Implementation: Collaborate with internal teams and external vendors to implement necessary integrations tailored to client needs.

Technical Support: Provide technical guidance and support to the engineering team regarding challenges and opportunities related to claims processing.

Best Practices Development: Establish and promote best practices and standards in claims adjudication and system architecture to enhance efficiency and effectiveness.

Vendor Communication: Serve as the primary point of contact for vendors, ensuring effective communication and timely issue resolution.

Collaboration: Work closely with cross-functional teams to facilitate system rebuilds or replacements, ensuring alignment with overall business goals.

Qualifications:

Technical Proficiency: Familiarity with the Impact system or similar claims management platforms; strong knowledge of DBC coding or similar languages.

Experience: Proven experience in claims processing and adjudication, with a solid understanding of healthcare claims management.

Skills: Excellent problem-solving and communication skills, with the ability to work collaboratively in a fast-paced environment.

Attributes: Strong critical thinking abilities, with exceptional organizational and detail-oriented skills.

S&S Health is committed to providing a safe and secure workplace for all employees. Please note that all final candidates will undergo a comprehensive background check and drug testing as part of our hiring process.

Hybrid remote