This position specializes in the analysis and application of intermediate level benefit plan design requirements. A successful Analyst will ensure a high level of quality and accuracy through benefit configuration, test execution and validation efforts while serving as a subject matter expert on benefits and claim adjudication system coding setup.
Job Description
- Analyzes new business requirements for benefit design changes to establish the appropriate solution.
- Complies with standards set forth regarding benefit design and configuration including but not limited to Health Insurance Portability and Accountability Act of 1996 (HIPAA) and National Council for Prescription Drug Programs (NCPDP).
- Maintains technical documentation based on standard operating procedures.
- Partners with various teams to analyze customer specific requirements and configuration and translate those into technical design specification and data flow from which programs are developed and coded.
- Actively participates in and contributes to daily communications, team meetings and project/issue resolution.
- Responsible for accurate management of plan benefits coding changes, test execution and validation efforts of plan benefit design requests.
- Maintains customer documentation that validates configuration.
- Efficiently and effectively distributes tasks, using clear and concise instructions and expectations.
- Completes deliverables independently and within an agile team setting.
- Other duties as assigned.
Responsibilities
- 2+ years of experience in benefit plan configuration/analysis.
- Experience with adjudication processes (FirstRx preferred), analyzing benefit plan design and system application.
- Advanced working knowledge of Microsoft office products (specifically Word, Access, Excel), including running queries and macros.