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Healthcare Benefit Plan Analyst

2 months ago


Minneapolis, Minnesota, United States Russell Tobin & Associates Full time
Job Summary

We are seeking a highly skilled Benefit Design Configuration Analyst to join our team at Russell Tobin & Associates. As a key member of our team, you will be responsible for executing the build and implementation of benefit plan adjudication requirements.

Key Responsibilities
  • Develop and implement benefit plan adjudication rules and configurations
  • Coordinate the integration or conversion of new clients and/or products as needed, often under aggressive timelines
  • Participate in the development and implementation of an enterprise claim platform, providing subject matter expertise on system configuration and usability components
  • Align operational needs with technology requirements
  • Develop best practices and standard operational procedures for creating and configuring benefit plans
  • Establish consistency and standardization as it relates to tools and processes
  • Curate a robust testing suite that is representative of all coverage to better quantify the impact of introducing configuration changes
  • Analyze issues/defects and debug the system when configuration is not producing the expected results
  • Partner with claim processors, member service, and provider service to identify and resolve issues related to plan configuration
Requirements
  • High school diploma or equivalent
  • Excellent analytical skills with ability to read and understand complex data and make thoughtful, articulate recommendations
  • Experience with project methodology (requirements, design, development, testing, and implementation) including understanding Agile, inclusive of Scrum and Kanban
  • Must be able to understand complex business processes that cross many functional operational units
  • Knowledge of ICD-10, CPT, HCPCS, revenue codes, and medical terminology
  • Demonstrated proficiency with Microsoft Excel and SQL
  • Knowledge and experience in a healthcare environment with HIPAA, ERISA, and ACA requirements
Nice to Have
  • Knowledge of commercial health plan design
  • Experience assisting in the plan build/plan configuration of claim adjudication platform
  • Working in an ambiguous, fast-paced environment
  • Agile, ready to change direction on the fly
Benefits

Russell Tobin & Associates offers eligible employees comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance, and hospital indemnity), a 401(k)-retirement savings, life & disability insurance, an employee assistance program, identity theft protection, legal support, auto and home insurance, pet insurance, and employee discounts with some preferred vendors.