Overview
Remote
On Site
USD 43,190.00 - 64,770.00 per year
Full Time
Skills
Standard operating procedure
Attention to detail
Policies and procedures
Test execution
Business requirements
Health insurance
Technical writing
Technical drafting
Data flow
Issue resolution
Critical thinking
Analytical skill
Microsoft Office
Security controls
Design
Software development
Accountability
HIPAA
NCPDP
Specification
Management
Documentation
Agile
Microsoft Excel
Macros
Leadership
Training
Law
Legal
Job Details
Our work matters. We help people get the medicine they need to feel better and live well. We do not lose sight of that. It fuels our passion and drives every decision we make.
Job Posting Title
Benefit Plan Configuration Analyst/CAPS exp required - REMOTE
Job Description Summary
This position specializes in the analysis and application of intermediate level benefit plan design requirements. A successful Analyst will ensure a high level of quality and accuracy through benefit configuration, test execution and validation efforts while serving as a subject matter expert on benefits and claim adjudication system coding setup.
Job Description
Responsibilities
Work Experience
Work Experience - Required:
Benefit Plan Configuration
Work Experience - Preferred:
Education
Education - Required:
A Combination of Education and Work Experience May Be Considered., Bachelors
Education - Preferred:
Certifications
Certifications - Required:
Certifications - Preferred:
Potential pay for this position ranges from $43,190.00 - $64,770.00 based on experience and skills. Pay range may vary by 8% depending on applicant location.
To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page and click on the "Benefits at a glance" button for more detail.
Prime Therapeutics LLC is an Equal Opportunity Employer and a Tobacco-free workplace . We encourage diverse candidates to apply and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), sexual orientation, gender identity or expression, genetic information, marital status, family status, national origin, age, disability, veteran status, or any other legally protected class under federal, state, or local law. Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures .
Positions will be posted for a minimum of five consecutive workdays.
Job Posting Title
Benefit Plan Configuration Analyst/CAPS exp required - REMOTE
Job Description Summary
This position specializes in the analysis and application of intermediate level benefit plan design requirements. A successful Analyst will ensure a high level of quality and accuracy through benefit configuration, test execution and validation efforts while serving as a subject matter expert on benefits and claim adjudication system coding setup.
Job Description
- Analyzes new business requirements for benefit design changes to establish the appropriate solution.
- Complies with standards set forth regarding benefit design and configuration including but not limited to Health Insurance Portability and Accountability Act of 1996 (HIPAA) and National Council for Prescription Drug Programs (NCPDP).
- Maintains technical documentation based on standard operating procedures.
- Partners with various teams to analyze customer specific requirements and configuration and translate those into technical design specification and data flow from which programs are developed and coded.
- Actively participates in and contributes to daily communications, team meetings and project/issue resolution.
- Responsible for accurate management of plan benefits coding changes, test execution and validation efforts of plan benefit design requests.
- Maintains customer documentation that validates configuration.
- Efficiently and effectively distributes tasks, using clear and concise instructions and expectations.
- Completes deliverables independently and within an agile team setting.
- Other duties as assigned.
Responsibilities
- Up to 2 years of experience in benefit plan configuration/analysis.
- Experience with adjudication processes (FirstRx preferred), analyzing benefit plan design and system application.
- This role requires strong attention to detail, critical thinking and analytical skills
- Strong working knowledge of Microsoft Office suite, specifically Word and Excel, including running queries and macros.
- Ability to work within a team and as an individual contributor in a fast-paced, changing environment.
- Ability to identify and resolve process and/or systems issues.
- Strong sense of urgency leading to the timely completion of all projects, training and assignments.
Work Experience
Work Experience - Required:
Benefit Plan Configuration
Work Experience - Preferred:
Education
Education - Required:
A Combination of Education and Work Experience May Be Considered., Bachelors
Education - Preferred:
Certifications
Certifications - Required:
Certifications - Preferred:
Potential pay for this position ranges from $43,190.00 - $64,770.00 based on experience and skills. Pay range may vary by 8% depending on applicant location.
To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page and click on the "Benefits at a glance" button for more detail.
Prime Therapeutics LLC is an Equal Opportunity Employer and a Tobacco-free workplace . We encourage diverse candidates to apply and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), sexual orientation, gender identity or expression, genetic information, marital status, family status, national origin, age, disability, veteran status, or any other legally protected class under federal, state, or local law. Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures .
Positions will be posted for a minimum of five consecutive workdays.