Benefit Configuration Analyst – 100% Remote
Pittsburgh, PA, USA
The Denzel Group has been chosen by a top Health Insurance company to search for a Benefits Configuration Analyst.
This is a permanent position and will be 100% remote. Our client offers a competitive base salary, excellent benefits, and growth opportunity.
In this role you be responsible for ensuring plan design within the claims adjudication systems is accurately built to adjudicate claims to match contractual/health plan design rules.
Analyze and understand TPA business requirements to implement effectively and creatively
Medical/Dental/Vision/FSA benefit plan designs developing necessary claims rules within claims adjudication system
Serve as resource and liaison to leadership and IT regarding Group Health/claims related concerns.
Understand the intricacies of plan member eligibility, provider networks and benefits to meet the needs of varied clients.
Investigate and troubleshoot system issues reported by Group Health staff, engaging IT when necessary.
5 years equivalent experience in health plan administration.
5 years in healthcare benefits administration focused on plan building, claims operations and claims system hierarchy designs as well as claims processing experience
Strong interpersonal and communication skills.
To apply please send your application to firstname.lastname@example.org
heath insurance, claims systems, systems analyst, facets, qiclink