Complex Benefit Configuration Expert

7 days ago


Frankfort, Kentucky, United States Prime Therapeutics Full time

About Us

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At Prime Therapeutics, we are dedicated to delivering exceptional healthcare solutions that make a real difference in people's lives. Our team is passionate about improving the health and well-being of our members, and we're seeking a skilled Complex Benefit Configuration Expert to join our dynamic team.

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Job Summary

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We are looking for an experienced professional to design, analyze, and implement advanced benefit coding change requests with a high degree of accuracy. The ideal candidate will possess strong attention to detail, critical thinking, and analytical skills, with the ability to work effectively in a fast-paced environment.

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Key Responsibilities

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  • Designs, analyzes, and implements benefit coding change requests with a high degree of accuracy.">
  • Gathers and analyzes client requirements, assessing the benefit impact on current design and claims processing, and presents options to stakeholders.">
  • Responsible for managing less standardized plan design concepts, clients, and programs from a coding, testing, and validation perspective.">
  • Facilitates conversations within the team to define client intent or program setup.">
  • Partners with various teams to analyze customer-specific requirements and configuration, translating those into technical design specifications and data flow.">
  • Actively participates in daily communications, team meetings, and project/issue resolution.">
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Requirements

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To be successful in this role, you will need:

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  • 2+ years of experience in benefit plan configuration/analysis.">
  • Experience with adjudication processes (FirstRx preferred), analyzing benefit plan design, and system application.">
  • Advanced working knowledge of Microsoft Office products (specifically Word, Access, Excel), including running queries and macros.">
  • Strong attention to detail, critical thinking, and analytical skills.">
  • Ability to work effectively in a fast-paced environment.">
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What We Offer

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In addition to the opportunity to work with a talented team and contribute to the success of Prime Therapeutics, we offer a competitive salary range of $52,250.00 - $78,390.00 based on experience and skills. Our benefits package includes medical, dental, vision, 401(k) matching, and more. We also provide opportunities for professional growth and development.

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How to Apply

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If you're a motivated and detail-oriented individual with a passion for complex benefit configuration, we encourage you to apply for this exciting opportunity. Please submit your resume and cover letter for consideration.

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