Benefits Configuration Analyst
New
S
SmithRxHealth-Tech
Location: RemoteFull-TimeMiddle
SalaryZone A: $66,300—$78,000 USD; Zone B: $60,800—$71,500 USD; Zone C: $55,300—$65,000 USD
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Job Details
- Experience
- 4+ years of experience
- Required Skills
- Microsoft Excel
Requirements
- 4+ years of experience in payer/claims and benefit configuration.
- Strong analytical skills.
- Proficiency in Microsoft Excel.
- Strong communication skills (face-to-face, conference calls, written).
- Self-starter mentality with the ability to make informed decisions.
- Execution-focused and solutions-oriented problem solver.
- Ability to work under the pressure of a fast-paced technology company.
- Dependable and adaptable.
Responsibilities
- Work with clients to identify and understand benefit plan requirements.
- Build and maintain pharmacy benefit plans for client groups.
- Monitor plan data integrity to organize benefit configuration and structure.
- Maintain prior authorizations and step therapy rules.
- Update formularies and transition new clients at the direction of the clinical team.
- Collaborate with member support and customer success teams to resolve benefit inquiries.
- Provide troubleshooting support for the claims adjudication process.
- Support new client implementations, including go-live testing and post-go-live auditing.
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