Benefits Configuration Analyst
SmithRx
full-time
Posted on:
Location Type: Remote
Location: Remote • Arizona, California, Colorado, Florida, Kansas, Minnesota, Montana, Nevada, New Jersey, Ohio, Pennsylvania, Tennessee, Texas, Utah, Virginia, Washington, Wisconsin • 🇺🇸 United States
Visit company websiteJob Level
Mid-LevelSenior
About the role
- Work with clients, identifying and understanding benefit plan requirements. Build and maintain pharmacy benefit plans for client groups.
- Aid in the organization of benefit configuration and structure for the accounts assigned by monitoring plan data integrity.
- Assist in determining process improvement efforts.
- Maintain prior authorizations and step therapy rules.
- Grandfather/transition new clients and update formularies with changes at the direction of the clinical team.
- Communicate project status, escalating issues when appropriate. Provide insight into changes to improve workflow efficiency.
- Collaborate with member support and customer success teams to review and resolve inquiries related to benefits timely to improve member experience.
- Provide troubleshooting support for our claims adjudication process.
- Support new client implementations, conduct go-live testing, perform post go-live auditing and support to ensure plans are configured to confirm accuracy.
Requirements
- 4+ years of experience in payer/claims and benefit configuration required.
- Analytical skills; Microsoft Excel skills;
- Strong communication skills via face-to-face meetings, conference calls and written correspondence.
- Self-starter mentality: ability to make informed decisions, find creative approaches to difficult challenges, and deliver on commitments.
- Execution-focused ethos - you are a solutions-oriented problem solver and efficiency driven.
- Flexible, dependable, adaptable, and able to respond under the pressure of a fast-paced technology company.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
benefit plan configurationpharmacy benefit plansdata integrity monitoringprocess improvementprior authorizationsstep therapy rulesformulary updatesclaims adjudicationgo-live testingpost go-live auditing
Soft skills
analytical skillsstrong communication skillsself-starter mentalitysolutions-oriented problem solverexecution-focusedflexibledependableadaptableability to respond under pressurecreative problem solving