Senior Benefits Configuration Tester
New
S
SmithRxHealth-Tech, PBM
RemoteFull-TimeSenior
Salary not disclosed
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Job Details
- Experience
- Minimum of 2 - 4 years of related experience
- Required Skills
- Data AnalysisMicrosoft ExcelHIPAA
Requirements
- Minimum of 2 - 4 years of related experience in benefits configuration or testing in healthcare.
- Associate degree or equivalent work experience.
- Strong understanding of benefit design standards, including HIPAA and NCPDP.
- Moderate skills in Microsoft Excel.
- Strong critical thinking skills, including analyzing data and drawing logical conclusions.
- Ability to work with little instruction on daily tasks.
- Effective written and verbal communication and presentation skills.
- Active listening skills to facilitate cross-functional collaboration.
Responsibilities
- Organize testing suites, create test plans, and submit moderately difficult test cases to validate the accuracy of complex benefit configuration setups.
- Serve as a key liaison with senior members of the Benefit Operations team to resolve configuration discrepancies, clarify plan designs, and report actionable insights.
- Provide support, guidance, and peer review for junior team members to ensure testing accuracy and understanding of claims adjudication systems.
- Handle Advanced Logic Validation such as Clinical/Prior Authorization and Financial Accumulators to ensure accurate cost-shares and out-of-pocket maximums.
- Document detailed defect reports for issues uncovered during testing and assist in the development of process improvements.
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