Benefit Design and System Support Analyst
Liviniti
full-time
Posted on:
Location Type: Remote
Location: Florida • United States
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About the role
- Provides Liviniti employees and customers with comprehensive knowledge of the claim processing system.
- Answers questions and assists with problem resolution.
- Manages tickets within a ticketing system; troubleshoots and resolves tickets that are placed in the claims processing queues in a timely manner.
- Adjudicates information on multiple software platforms.
- Enforces procedures that are put in place by the Benefit Design Supervisor, Director of Claims Processing, and other Leadership.
- Identifies and corrects Benefit Design errors within the claims processor based on client documentation.
- Provides and potentially presents audit findings to Account Management and, on occasion, the Leadership team.
- Facilitates benefit designs for new clients within the claims processor based off of documentation.
- Communicates with the Implementation team to discuss and/or ask questions regarding benefit designs for new clients.
- Works in conjunction with the Clinical team to input information into the claims processor and makes updates based on extensive testing to ensure the clinical request is to appropriate specifications.
- Assists Customer Service Representatives with troubleshooting and resolving issues within our claims processor, when appropriate.
- Works in conjunction with an external programming team to analyze and resolve programming error(s) within our claims processor.
Requirements
- Associate or Bachelor’s degree preferred.
- 2 to 3 years’ previous experience working in PBM environment, health plan, pharmacy chain, or managed care services organization in a Systems or Plan Design capacity.
- Intermediate or advanced proficiency with MS Excel, Word, PowerPoint, Outlook
- Excellent verbal and written communication skills, establishing rapport and working with others.
Benefits
- Medical, Dental, Vision insurance
- Disability and Life insurance
- Employee Assistance Program
- Generous Paid-Time Off
- Annual Reviews and Development Plans
- Retirement Plan with company match immediately 100% vested
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
claim processingticket managementproblem resolutionadjudicationbenefit designdata analysisprogramming error resolutionextensive testingdocumentation review
Soft Skills
communicationcollaborationproblem-solvingrapport buildingpresentation skills