Support implementation and client management teams with all day-to-day client requirements
Responsible for timely and accurate management and execution of all client benefit requests, including benefit changes, eligibility changes, and new implementations
Analyze incoming client requests and work with internal and external teams to complete required plan documentation
Support implementation of new plans, pricing, and networks, consistent with strategic or administrative intent
Lead pre- and post-implementation quality assurance and testing to validate coding accuracy
Lead claim reviews to proactively identify discrepancies or inaccuracies and develop solutions to address
Handle and resolve sponsor and member issues, escalating as needed
Research and respond to claims processing and system configuration inquiries
Coordinate integration of other data inputs into client management processes
Collaborate cross functionally to support general client operations, as required

Requirements

Undergraduate bachelor’s degree, with record of strong academic performance or equivalent job experience
1+ years of proven experience in PBM / health plan, benefits consulting, healthcare
Track record of building trusting internal and external relationships
Track record of leading cross-functional initiatives, driving high performance, meeting deadlines, and executing on deliverables
Experience working with structured and unstructured data
Proficient in Microsoft Office, SQL a bonus
Ability to balance multiple complex projects simultaneously
Exceptional written and verbal communication skills
Extremely flexible, highly organized, and able to shift priorities easily
Attention to detail & commitment to delivering high quality work product

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools

data analysisquality assuranceclaims processingsystem configurationproject managementbenefit managementeligibility managementdocumentationcoding accuracydata integration

Soft Skills

communicationrelationship buildingcross-functional collaborationorganizational skillsflexibilityattention to detailproblem-solvingtime managementleadershiphigh performance