Business Systems Specialist

About the Role

The Business System Specialist is responsible for configuring the systems used to maintain business and operational requirements. This role provides technical support to internal teams for issues related to claims, file feeds, and eligibility. The specialist works closely with TPA Operations, Implementation and Renewal teams, developers, and project management to configure groups within the claims system, support testing for external vendor onboarding, and troubleshoot day-to-day issues affecting members, employers, and external vendors.

The ideal candidate is highly organized, self-motivated, and possesses strong problem-solving skills. This individual demonstrates a strong sense of urgency and excels in a fast-paced environment.

Responsibilities

• Configure and QA claims system to support new group and renewal onboarding.
• Assist with external vendor onboarding and project initiatives with system testing, validation, and quality assurance.
• Troubleshoot and resolve technical or configuration issues for internal teams and coordinate with vendors when necessary.
• Support software implementations, upgrades, and system migrations.
• Assist with data validation, imports, exports, and system integrations.
• Ensure compliance with organizational security, governance, and audit requirements.
• Other tasks as assigned.

Qualifications

• 3–5 years of experience configuring enterprise applications or business systems.
• Experience with claims administration systems and electronic data interchange (EDI).
• Strong troubleshooting and problem-solving skills.
• Experience with system testing and documentation.
• Excellent verbal and written communication skills.
• Ability to manage multiple priorities in a fast-paced environment.
• Understanding of PII, PHI, and HIPAA compliance.

Preferred Qualifications

• Experience working with or within a Third-Party Administrator (TPA).
• Experience in API integrations is a plus.

Schedule

Full-time, remote position aligned with U.S. business hours. Flexibility required for critical project deadlines, cross-functional meetings, and occasional travel (0–10%) for team collaboration or vendor engagements.

Remote Work Requirements

• Dedicated home office with reliable, high-speed internet.
• Secure workspace aligned with HIPAA security standards (device encryption, secure Wi-Fi, screen privacy).
• Ability to effectively coordinate and lead projects in a fully remote environment.

Security, Privacy & Compliance

This position requires adherence to Tres Health’s security and privacy policies, including HIPAA compliance. All employees must complete security training and comply with access management protocols.

Physical Requirements

• Prolonged periods of sitting and working at a computer.
• Ability to communicate effectively through video, phone, and written platforms.
• Ability to effectively use computers, video conferencing tools, and other standard remote work technology.
• Ability to occasionally lift up to 15 pounds.

Tres Health is committed to ADA compliance and will provide reasonable accommodations to individuals as needed.