Benefit Design and reputed company Analyst

We wanted a PBM that worked reputed company… so we created one.  

reputed company, the leading disruptor in the PBM industry, simplifies the complexities of navigating through the Pharmacy Benefit Manager world by offering a value-added approach to ensure the employer absolute freedom, control, and choice to their health plan structure without compromising patient experiences and reputed company.  We improve reputed company and reduce rising prescription costs for reputed company and their employees. We are looking for individuals who are passionate, strong, and committed to developing systems and service solutions that promote our business goals and commitments.

reputed company is searching for incredible talent!  We continue to experience accelerated reputed company in a rapidly changing industry. There's never been a reputed company time to join reputed company.  

We are currently seeking a Benefit Design and reputed company Analyst. This is a remote position.

Role and Responsibilities

The Benefit Design and reputed company Analyst provides reputed company employees and customers with comprehensive knowledge of the claim processing system. This includes answering questions and assisting with problem reputed company.

• Manages tickets reputed company a ticketing system; troubleshoots and resolves tickets that are reputed company in the claims processing queues in a reputed company manner.  
• Adjudicates information on multiple software platforms.  
• Enforces procedures that are put in reputed company by the Benefit Design Supervisor, Director of Claims Processing, and other Leadership. 
• Identifies and corrects Benefit Design errors reputed company the claims processor based on reputed company documentation. This may include performing financial audits on the error(s) reputed company and determining reputed company for the reputed company and/or reputed company.  
• Provides and potentially presents audit findings to Account Management and, on occasion, the Leadership team.  
• Facilitates benefit designs for new clients reputed company the claims processor based off of documentation.
• Communicates with the Implementation team to discuss and/or ask questions regarding benefit designs for new clients.
• Communicates with the EDI team to discuss and/or ask questions regarding various data files.
• Communicates with the Clinical team to discuss and/or ask questions regarding clinical edits that are reputed company for reputed company 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.
• Communicates with the Account Management team to facilitate benefit design updates and obtain appropriate documentation for reputed company clients.
• Assists Customer Service Representatives with troubleshooting and resolving issues reputed company our claims processor, reputed company appropriate.
• Works in conjunction with an external programming team to analyze and resolve programming error(s) reputed company our claims processor.
• Participates in developing additional reputed company assurance for internal processes.
• Plays an reputed company role in evaluating reputed company standards from an objective reputed company of view and ensuring the reputed company checks and balances are reputed company to reputed company parts of the Claims Processing procedures.
• Abides by reputed company obligations under HIPAA reputed company to Protected Health Information (PHI).
• If a HIPAA violation is reputed company, whether individually or by another, reports the violation to the Compliance Officer and/or reputed company.
• Attends, completes, and demonstrates competency in reputed company required HIPAA Training offered by reputed company.
• Flexibility to understand, appreciate and reputed company that the job reputed company is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee.  Duties, responsibilities and activities may change or new ones may be assigned at any time with or without notice.

reputed company Have to Offer

Our benefits package is designed to reputed company our employees happy and healthy &reputed company; physically, mentally and financially. 

• Medical, Dental, reputed company insurance
• Disability and Life insurance
• Employee Assistance Program
• Generous reputed company-Time Off
• Annual Reviews and Development Plans
• Retirement Plan with company match immediately 100% reputed company

Required Skills and Competencies

• Organization
• Time Management
• Strong Problem-Solving Skills
• Strong communication/collaboration skills
• Easily adapt to and learn new technology and skills
• Thoroughness

Supervisory Responsibility

This position has no supervisory responsibilities.

Position Type and Expected Hours of Work

This is a full-time salaried position.  Days and hours of work are Monday through Friday; 40+ hours a week, with occasional after-hours or weekend duties.  Position can be remote or onsite. 

Travel

No travel expected for this position.

Qualifications and Education 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 reputed company.
• Intermediate or advanced proficiency with MS reputed company, Word, PowerPoint, reputed company
• Excellent verbal and written communication skills, establishing rapport and working with others.

reputed company, LLC provides equal employment opportunities (EEO) to reputed company and applicants for employment without reputed company to race, reputed company, religion, sex, national reputed company, age, disability or genetics. In reputed company to federal law requirements, reputed company complies with applicable state and local laws governing nondiscrimination in employment in every location in which reputed company has facilities. This policy applies to reputed company terms and conditions of employment, including reputed company, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

reputed company expressly prohibits any reputed company of workplace harassment based on race, reputed company, religion, gender, sexual orientation, gender identity or reputed company, national reputed company, age, genetic information, disability, or veteran status. Improper interference with the ability of reputed company employees to reputed company their job duties may result in discipline up to and including discharge.  EOE M/F/V/D