Plan Administration Specialist
MedOne Pharmacy Benefit Solutions
full-time
Posted on:
Location Type: Remote
Location: Iowa • Kansas • United States
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About the role
- Support the PLAD team with implementation efforts, including plan-building activities within the claims adjudication system for new and existing clients.
- Assist with testing plan builds, system changes, and program modifications while documenting testing results.
- Assist with testing software releases. This includes both regression testing and software enhancements.
- Maintain accountability for timely resolution of configuration errors.
- Monitor claims for processing errors.
- Research and respond to claim inquiry questions.
- Assist with documenting, building, maintaining, and testing pharmacy networks.
- Assist with recording processes and documentation to support the PLAD team and Business Architecture.
- Educate others on system capabilities, system implementation approach, and test results.
- Cultivate positive relationships and collaborate effectively with internal teams.
- Participate in ongoing professional development to stay updated on the latest Pharmacy Benefits Management (PBM) products and services.
- Perform other duties as assigned by the supervisor.
Requirements
- Associate’s degree or equivalent work experience
- 1–3 years of experience in a Pharmacy Benefits Management (PBM) environment, with preferred experience in claims processing systems, plan design system implementation, or pharmacy network system management
- Exceptional critical thinking and problem-solving skills
- Exceptional organizational, time management, and multitasking skills
- Proficiency in Microsoft Office products (Word, Excel).
Benefits
- Competitive salary and bonuses that reward your performance.
- Comprehensive health, dental, and vision insurance + additional benefits
- 401(k) with company match to secure your future.
- Generous paid time off and holidays.
- Opportunities for professional growth and development.
- A vibrant and collaborative work culture.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
claims adjudicationregression testingsoftware enhancementsconfiguration managementpharmacy network managementplan design system implementationclaims processing systems
Soft Skills
critical thinkingproblem-solvingorganizational skillstime managementmultitaskingcollaboration
Certifications
Associate’s degree