<p>Configuration Specialist - Provider</p> <p>SummaCare - 1200 E Market St, Akron, OH</p> <p>Full-Time / 40 Hours / Days</p> <p>Hybrid after training</p> <p>SummaCare is a Summa Health entity that offers health insurance in northern Ohio. As a regional, provider-owned health plan, SummaCare is based in Akron, Ohio, and provides Medicare Advantage, individual and family and commercial insurance plans. SummaCare has one of the highest rated Medicare Advantage plans in the state of Ohio, with a 4.5 out of 5-Star rating for 2025 by the Centers for Medicare and Medicaid Services (CMS). Known for its excellent customer service and personalized attention to members, SummaCare is committed to building lasting relationships. Employees can expect competitive pay and benefits.</p> <p>Summary:</p> <p>Performs provider demographic and network configuration, testing and implementation in claims system and surrounding systems as needed to efficiently and accurately adjudicate claims and support reporting processes.</p> <p>Formal Education Required:</p> <ul> <li>Associate Degree in business or healthcare-related field or equivalent combination of education and experience. </li></ul> <p>Experience & Training Required:</p> <ul> <li>Two (2) years experience to include claims processing, provider credentialing, provider contracting or and/or working knowledge of claims/provider data elements that support healthcare operations. Amisys system experience preferred. </li></ul> <p>Other Skills, Competencies and Qualifications:</p> <ul> <li>Microsoft Office; Word and Excel at an intermediate level and Access at a beginner level </li><li>Microsoft SQL Server Management Studio strongly desired </li><li>Ability to communicate in a professional manner to a wide variety of audiences, including Senior Leadership. This includes presentations, correspondence, instructional material, reports, policies and procedures, legal and or technical documents. Excellent proofreading skills. </li><li>Strong analytical skills to review data from a variety of sources in order to make recommendations/conclusions based on the outcomes. </li><li>Excellent attention to detail and strong trouble shooting skills. </li><li>Organize and manage time to accurately complete tasks within defined timeframes in a fast-paced, often changing environment. </li><li>Maintain current knowledge of and comply with regulatory and business information. </li><li>Maintain confidentiality of member health and business information. </li><li>Independent judgement, decision making, problem solving. </li></ul> <p>Level of Physical Demands:</p> <ul> <li>Light: Exerts up to 20 pounds of force occasionally and/or up to ten pounds of force frequently, and/or a negligible amount of force continuously. </li></ul> <p>Equal Opportunity Employer/Veterans/Disabled</p> <p>$33.08/hr - $39.70/hr</p> <p>The salary range on this job posting/advertising is base salary exclusive of any bonuses or differentials. Many factors, such as years of relevant experience and geographical location are considered when determining the starting rate of pay. We believe in the importance of pay equity and consider internal equity of our current team members when determining offers. Please keep in mind that the range that is listed is the full base salary range. Hiring at the maximum of the range would not be typical.</p>