Tempe, AZ, 85282, USA
7 days ago
Benefit Configuration Specialist
Job Description: -Applies pharmacy, formulary, and benefit configuration to effectuate change as specified in submitted change requests. Ensures assigned due dates for submitted change requests are met. -Troubleshoots and performs research on basic claims adjudication issues or inquiries -Acquires a thorough understanding of Medimpact system logic for claims adjudication, system constraints, conflicting benefit logic configurations, benefit coding table designs, plan - group - pharmacy carrier to benefit linking, to ensure proposed design satisfies the intended solution. -Ensures consistent customer satisfaction through consultation and collaboration with internal business partners to ensure that business requirements for submitted change requests are clearly understood, documented, developed, communicated, tested, and delivered flawlessly -Uses standardized methodology to ensure that appropriate rationale exists for non-standard design and that all efforts are undertaken to prevent inefficient and non-sustainable configuration structures -Reviews results of in-unit testing in order to validate new plan configurations -Assists in creating and maintaining documentation of clients' plan designs, detailing any custom maintenance processes and configuration best practices. Includes documentation of adjudication hierarchies, edits, restrictions, tables, carriers, and other configuration components. -Utilizes project planning, prioritizing, and organizational skills to ensure timely deliverables, high levels of quality, and efficient use of resources to achieve claims adjudication accuracy Expectations: -Interpret a variety of detailed and complex instructions furnished in written, verbal diagrams, or work and data flows. -Apply concepts such as fractions, percentages, ratios and proportions to practice situations -Read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations -Write reports, business correspondence, and procedure manuals -Present information and respond to questions from groups of managers, clients, customers, and the general public -Gather business requirements and client specifications. -Positively interact with clients, internal customers and peers. -Willingness to take accountability for achieving service commitments and a demonstrated ability to achieve results -Appear for work on time, follow directions from supervisor, interact well with co-workers, understand and follow work rules and procedures, comply with corporate policies, goals, and objectives, accept constructive criticism, establish goals and objectives, and exhibit initiative and commitment Pay and Benefits The pay range for this position is $21.00 - $21.00/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: • Medical, dental & vision• Critical Illness, Accident, and Hospital• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available• Life Insurance (Voluntary Life & AD&D for the employee and dependents)• Short and long-term disability• Health Spending Account (HSA)• Transportation benefits• Employee Assistance Program• Time Off/Leave (PTO, Vacation or Sick Leave) Workplace Type This is a fully onsite position in Tempe,AZ. Application Deadline This position is anticipated to close on Feb 26, 2025. About TEKsystems: We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company. The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
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