Expert Benefits Analyst
2 weeks ago
About the role:
Cultivate a dynamic environment with our organization's rapid growth and innovative spirit. This fosters numerous opportunities for individuals with an entrepreneurial mindset who want to make a lasting impact.
You will collaborate with colleagues from around the globe to create solutions for leading companies. These solutions enhance their agility, innovation, and success.
You will be part of a successful story and have the chance to make a difference in the world.
Job Overview- We are seeking an experienced benefits analyst to join our team.
- The ideal candidate will bring expertise in configuring benefits structures, focusing on provider contracting, claims adjudication, and benefit plan setup.
- This role requires a strong understanding of the healthcare domain and hands-on experience with benefits configuration within our platform.
Qualifications:
- Engineering or bachelor's degree or equivalent qualification with minimum 3-6 years of relevant hands-on experience in benefits configurations and claim validation.
- Strong knowledge in API testing and EDI 278 transactions.
- Hands-on experience in SQL database testing.
- Configure and maintain benefits structures within our platform.
- Set up and manage network pricer, benefit plans, and related configuration components.
- Collaborate with provider contracting teams to translate business rules into system configuration.
- Analyze and support claims adjudication processes related to benefits discrepancies or escalations.
- Ensure compliance with Medicare, Medicaid, and commercial payer guidelines.
- Participate in testing and validation of benefits setups to ensure accurate claim outcomes.
- Document configuration changes and maintain audit-ready records.
- Work with cross-functional teams including IT, business analysts, and QA to implement and troubleshoot system changes.
A unique opportunity to work in a dynamic environment with a chance to make a lasting impact.
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