Healthcare Advisor- Third-Party Administrator

1 month ago


Boston, United States BigRio Full time

Position: Healthcare Advisor- Third-Party Administrator (TPA) integration with Software solutions

Location: Remote

Employment Type: Part-time/Contract- 10-15 hours in a week


Job Summary:

We are seeking a highly skilled and knowledgeable Healthcare Advisor with extensive experience integrating with third-party administrator (TPA) processes. You should have comprehensive functional, operational, and technical expertise in working with and deploying solutions integrated with Healthcare TPA platforms. The ideal candidate will work with the software solution architects to integrate the TPA workflows and processes into the software platform. The role will be to facilitate the integration of TPA processes and workflows into the claims processing. This role requires a strong understanding of TPA functions, operational workflows, and the technical aspects of software architecture.


Key Responsibilities:

  • Functional Expertise:
  • Understand the management and administration of healthcare employee benefits plans.
  • Understand the integration of claims processing, adjudication, and payment functions into TPA vendors.
  • Operational Expertise:
  • Monitor and improve operational workflows to ensure timely and accurate processing of benefits and claims.
  • Guide the customization of vendor platforms to work seamlessly with TPA enterprise software.
  • Technical Expertise:
  • Collaborate with TPA’s and other software vendors to resolve technical issues and optimize system performance.
  • Ensure data integrity and security within benefits administration platforms.
  • Develop and maintain technical documentation and user guides for benefits administration systems.

Qualifications:

  • Bachelor's degree in Business Administration, Human Resources, Information Technology, or a related field.
  • Minimum of 10 years of experience in TPA functions, benefits administration, or a related field.
  • Strong experience on the TPA software vendor side.
  • Strong understanding of employee benefits plans, insurance policies, and regulatory requirements.
  • Proven experience in managing operational workflows and improving process efficiencies.
  • Technical proficiency in benefits administration software and systems (e.g., [specific systems]).
  • Excellent analytical, problem-solving, and decision-making skills.
  • Strong communication and interpersonal skills, with the ability to collaborate effectively with internal and external stakeholders.


Preferred Skills:

  • Experience with healthcare benefits and claims processing.
  • Familiarity with HL7 standards and healthcare application development.
  • Knowledge of database management and SQL.
  • Experience with Microsoft technologies and Azure.




Equal Opportunity Statement

BigRio is an equal opportunity employer. We prohibit discrimination and harassment of any kind based on race, religion, national origin, sex, sexual orientation, gender identity, age, pregnancy, status as a qualified individual with disability, protected veteran status, or other protected characteristic as outlined by federal, state, or local laws. BigRio makes hiring decisions based solely on qualifications, merit, and business needs at the time. All qualified applicants will receive equal consideration for employment.



  • Boston, United States Iron Mountain Inc Full time

    Report directly to the Manager of Third Party Risk Management for all things concerning the Third Party Risk Program, maintenance and administration Liaise with internal Subject Matter Experts (SMEs) and assessors (reviewers) of external assessment a Risk, Management, Analyst, Technology, Accounting, Business, Assessment


  • Boston, United States Commonwealth Care Alliance Full time

    Why This Role is Important to Us:The Senior Director, Third Party Compliance Oversight reports directly to the SVP, Corporate Compliance & Ethics and Risk Operations, and leads the Third-Party Compliance Oversight department for Commonwealth Care Alliance (CCA). This position effectively leads our Third-Party Compliance Oversight programs which includes...


  • Boston, United States Commonwealth Care Alliance Full time

    Why This Role is Important to Us:The Senior Director, Third Party Compliance Oversight reports directly to the SVP, Corporate Compliance & Ethics and Risk Operations, and leads the Third-Party Compliance Oversight department for Commonwealth Care Alliance (CCA). This position effectively leads our Third-Party Compliance Oversight programs which includes...


  • Boston, Massachusetts, United States Complete Staffing Solutions, Inc. Full time

    Job OverviewType: Temporary position, covering maternity leave, for a duration of 3 months.Schedule: Monday to Friday, from 7:30 AM to 4:00 PM.This position will function as a Patient Service Coordinator III in addition to performing Medical Assistant duties, primarily focusing on patient interactions. The role will also provide backup support for Medical...

  • Adjunct Faculty

    2 months ago


    Boston, United States Massachusetts College of Pharmacy and Health Sciences Full time

    Job DescriptionThe School of Healthcare Business & Technology seeks adjunct faculty members to deliver high-quality learning experiences and education for students in the Bachelor of Science in Healthcare Management program. The selected candidate will be responsible for teaching undergraduate students in the classroom.  Subject matter includes healthcare...


  • Boston, United States Third Rock Ventures Full time

    Job DescriptionJob DescriptionOur Boston office is looking for an Analyst to join the Private Markets Business Management Team, which sits within the broader Private Markets’ Chief Operating Officer team. This team is responsible for understanding the needs of our Private Markets clients and investment teams and helping execute to fulfill those needs in...


  • Boston, Massachusetts, United States Goodwin Recruiting Full time

    Job OverviewGoodwin Recruiting, a leading full-service recruiting agency, is seeking a seasoned Principal Wealth Manager to join their growing team. As a key player in shaping the future of wealth management through innovative Fintech solutions, this dynamic role requires a transferable book of business and a passion for delivering exceptional client...


  • Boston, Massachusetts, United States Veterans Sourcing Group Full time

    Job OverviewPosition Title: Senior Human Resources Administrator (401k Management)Compensation: $33 - $35 per hour (W2)Work Arrangement: Remote (preferred candidates located in the Northeast)Work Schedule: 40 hours per week, Monday to Friday, 7:30 AM to 4:00 PM, with overtime as requiredContract Length: 6 monthsPotential for Extension or Conversion: To be...

  • Lease Administrator

    5 days ago


    Boston, United States Lincoln Property Company Full time

    Job DescriptionJob DescriptionLincoln Property Company does not accept unsolicited resumes from third-party recruiters unless they were contractually engaged by Lincoln Property Company to provide candidates for a specified opening. Any such employment agency, person or entity that submits an unsolicited resume does so with the acknowledgement and agreement...


  • Boston, Massachusetts, United States Complete Staffing Solutions Full time

    Job OverviewWe are seeking a dedicated Healthcare Administrative Coordinator to join our team at Complete Staffing Solutions. This role is essential in ensuring the smooth operation of our medical office.Key Responsibilities:Communication: Manage incoming calls, providing accurate information and directing inquiries to the appropriate personnel. Welcome and...


  • Boston, United States SHP Management Corp Full time

    Job SummaryThe Assistant Property Manager provides administrative support to the Property Manager in the day-to-day operations of the property. This role is responsible for ensuring the smooth administration of the property, including answering inquiries, greeting tenants and visitors, and preparing reports.Key ResponsibilitiesAssist the Property Manager in...


  • Boston, Massachusetts, United States Tufts Medicine Full time

    Job SummaryWe are seeking a highly organized and detail-oriented Practice Coordinator to join our team at Tufts Medicine. This role will provide administrative support for our clinic providers and play a critical role in the hospital's revenue cycle process, clinic operations, and patient experience.Key ResponsibilitiesScheduling and Coordination: Schedule...


  • Boston, United States MassMutual Full time

    Director, Loan Asset Administration Center of Excellence (CoE) Full-Time Hybrid, Boston MA, Springfield MA, or New York, NYThe Opportunity We have an exciting transformational opportunity for a Director, Loan Asset Administration Center of Excellence (CoE) focusing on Bank Loan investment within Insurance General Account Portfolios.The team functions...


  • Boston, United States MassMutual Full time

    Director, Loan Asset Administration Center of Excellence (CoE) Full-Time Hybrid, Boston MA, Springfield MA, or New York, NYThe Opportunity We have an exciting transformational opportunity for a Director, Loan Asset Administration Center of Excellence (CoE) focusing on Bank Loan investment within Insurance General Account Portfolios.The team functions...


  • Boston, Massachusetts, United States TEKsystems Full time

    Job OverviewHealthcare Administrative Coordinator (Onsite)Contract to hire*This position provides administrative support within a renowned healthcare facility. Discover more about this engaging opportunity below...Advantages of This Position:Collaborate with a prestigious healthcare organizationExcellent opportunity to establish a career within a significant...


  • Boston, United States Simmons University Full time

    ABOUT SIMMONS Located in Boston’s historic Fenway area, Simmons has a strong tradition of empowering women and challenging traditional gender roles. Simmons University was one of the first higher education institutions to prepare women to become leaders and has evolved to become a university offering a women’s undergraduate program and graduate programs...


  • Boston, United States Simmons University Full time

    ABOUT SIMMONS Located in Boston's historic Fenway area, Simmons has a strong tradition of empowering women and challenging traditional gender roles. Simmons University was one of the first higher education institutions to prepare women to become leaders and has evolved to become a university offering a women's undergraduate program and graduate programs open...

  • System Administrator

    1 month ago


    Boston, United States firstPRO, Inc Full time

    firstPRO is now accepting resumes for a Success Factors System Administrator role in Waltham, MA. This is a 12+ month contract to hire and onsite once a week.Description: We are looking for a Success Factors expert to support our team. You'll bring with you a wealth of Success Factors systems know-how and act as an advisory, training, coaching and mentoring...

  • System Administrator

    1 month ago


    Boston, United States firstPRO, Inc Full time

    firstPRO is now accepting resumes for a Success Factors System Administrator role in Waltham, MA. This is a 12+ month contract to hire and onsite once a week.Description: We are looking for a Success Factors expert to support our team. You'll bring with you a wealth of Success Factors systems know-how and act as an advisory, training, coaching and mentoring...

  • Trust Advisor

    3 months ago


    Boston, United States Loring, Wolcott & Coolidge Trust, LLC Full time

    As a Fiduciary Services department member, this position supports the Trustees and Clients of Loring, Wolcott & Coolidge Trust, LLC. It involves handling multiple Client and Trustee needs with minimal supervision, making it necessary to adapt to various personalities and working styles. The Trust Advisor performs a wide range of complex trust administration...