Benefit Analyst III

This is a fully remote position, open to applicants in United States.

📋 Description

• Ensures client satisfaction by accurately designing and configuring benefits, which includes consulting and collaborating with external clients, brokers, and internal business partners.

• Oversees plan maintenance and processes benefit change requests for current clients, including annual updates to member cost-sharing and accumulators.

• Manages the pre-assessment of benefit change requests by conducting research to confirm that plan configurations align with client specifications, while offering options to fulfill client intentions.

• Employs the RxClaim operating system to design, construct, and maintain client plans and components.

• Conducts end-to-end testing and validation of plans to ensure that plan benefits conform to client specifications.

• Possesses the ability to identify and prioritize client needs, ensuring that all change requests are completed within client deadlines.

• Researches and provides insights for claim-related inquiries.

• Participates in external auditor reviews, including conducting claim research.

• Trains current team members as well as new hires.

• Willingness to work additional hours as required by workload demands.

• Performs additional duties as assigned.

⛳️ Requirements

• Bachelor’s degree or a combination of education and experience equivalent to that level.

• Expertise in the RxClaim adjudication platform, including experience in PBM benefit design.

• Capable of thriving in a fast-paced environment with minimal guidance while maintaining a high level of accuracy and attention to detail.

• Excellent verbal and written communication skills, including presentation capabilities and client relationship management.

• Able to set priorities and manage workflow to ensure timely, efficient, and accurate deliverables.

• Proficient in managing and negotiating multiple priorities and deadlines.

• Maintains a friendly and effective relationship with clients and colleagues, contributing to a collaborative team environment.

• Strong analytical skills.

🏝️ Benefits

• EOE M/F/D/V – WellDyne and HealthDyne are equal opportunity employers that prohibit discrimination of any kind.

• Health insurance.

• 401(k) matching.

• Flexible work hours.

• Paid time off.

• Remote work options.