Healthcare Fraud Shield

Detects fraud, waste, abuse in healthcare

Implementation Specialist

Implementation & Technical Account ManagementUpdated on Nov 13

Full-timeChesterfield, MO, USANo salary listed

About the Job

Requirements

A bachelor's degree is required.
One to two years of project management or related experience is required, preferably supporting efforts to configure and customize a system or product.
Advanced knowledge of Microsoft Office Suite, including Word, Excel, Project, and Outlook, is required.
A good working knowledge of web applications is essential.
The applicant must be proficient in the use of computers and computer applications.
The role requires the ability to prioritize and organize large volumes of projects.
The role requires the ability to solve problems and make decisions.
The role requires attention to detail.
The role requires the ability to work in a team environment.
The role requires organizational and time management skills.

Responsibilities

Plan and implement new client installations, including managing project timelines, analyzing data, ensuring documentation meets organizational standards, handling client outreach and communication, and monitoring and communicating project deliverable deadlines.
Manage assigned implementation tasks to a high standard.
Apply project management and organizational skills to implementation processes.
Use analytical and problem-solving skills to identify obstacles and impediments in the client onboarding process.
Analyze client data files at various stages throughout implementation, assist with documentation related to client data feeds, including mapping and special data manipulation, and assist with testing new client implementations.
Work effectively with internal teams to identify resources to address client data obstacles, milestone implementation tasks, and special client needs.
Communicate with clients professionally and promptly about data needs and concerns, provide status updates, and guide the installation process as needed.
Provide regular status updates to internal staff and client resources.
Manage project schedules and timelines in project management software and company project templates.
Deliver a high level of customer service.
Comply with company privacy and security standards.
Do not use or disclose protected health information except as permitted or required by law.
Perform other duties as needed, which may include data entry and research tasks.

Desired Qualifications

A focus in Health Insurance or Administration is preferred for the required bachelor's degree.
Three or more years of experience working with health insurance claim data or in a related industry is preferred.
Experience supporting efforts to configure and customize a system or product is preferred.
Experience in healthcare IT, clinical informatics, or Healthcare Fraud, Waste and Abuse (FWA) is strongly desired.
Knowledge of health care, insurance, medical terminology, CPT, HCPCS, DRG, Revenue, ICD-9, and ICD-10 is preferred.

As an Implementation Specialist, you will play a key role in the planning and implementation of new client installations including project timeline management, data analysis, ensuring documentation meet organizational standards, handling client outreach and communication, and monitoring and communicating project deliverable deadlines.

Manage assigned implementation tasks to the highest standards.
Apply strong project management and organizational skills to implementation processes.
Utilize analytical and problem-solving skills to identify obstacles and impediments in the client onboarding process.
Perform client data file analysis at various stages throughout the implementation process, assist in documentation related to client data feeds including mapping and special data manipulation needed, and assist in testing for new client implementations.
Ability to work effectively with internal team to discuss and identify resources to efficiently overcome client data obstacles as well as milestone implementation tasks and any special client needs.
Ability to communicate to clients in a professional and timely manner to discuss data needs and concerns, provide status updates, and guide the installation process as needed.
Provide regular status updates to both internal staff and client resources.
Manage project schedules and timelines in project management software and other company project templates.
Always deliver a high level of customer service.
Understands and complies with all company Privacy and Security standards.
Employee may not use or disclose any protected health information, except as otherwise permitted, or required, by law.
Other duties as needed which may include data entry and/or other research tasks.

Qualifications:

Bachelor’s degree required, focus Health Insurance or Administration preferred.
3+ years’ experience working with Health Insurance claim data or in a related industry preferred.
1-2 years project management or related experience, preferably supporting efforts to configure and customize a system or product.
Advanced knowledge of Microsoft Office Suite to include Word, Excel, Project, and Outlook.

Skills:

A good working knowledge of web applications is essential to this role. Experience in healthcare IT, clinical informatics, or Healthcare Fraud, Waste and Abuse (FWA) is strongly desired.
Proven knowledge of health care, insurance, medical terminology, CPT, HCPCS, DRG, Revenue, ICD-9, ICD-10 preferred.
Applicant must be proficient in the use of computers and computer applications.
Proven ability to prioritize and organize large volumes of projects.
Adept at solving problems and making decisions.
Excellent communication skills both verbal and written.
Attentive to detail.
Ability to work in a team environment.
Outstanding organizational and time management skills.
Self-motivated.

About the Company

Healthcare Fraud Shield

Detects fraud, waste, abuse in healthcare

Healthcare Fraud Shield provides fraud, waste, and abuse detection solutions for the healthcare industry through the FWAShield suite. The products include pre-payment and post-payment analysis that flag ineligible claims by linking proprietary data sources with analytics, plus features like real-time queries, complex reports, and automated case management. It differentiates itself by adapting quickly to client needs and offering scalable, data-driven tools combined with customization and expert claims analysis. Its goal is to reduce financial losses from improper payments and maximize ROI for healthcare providers, insurers, and other stakeholders.

Company size: 51-200
Company stage: Late Stage VC
Total funding: $50M
Headquarters: Chesterfield, MO
Founded: 2011

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