Benefits Configuration Analyst

Summary

Join PDMI as a Benefits Configuration Analyst and contribute to improving healthcare quality and efficiency! This fully remote role requires full knowledge of product-specific plan designs and benefit structures. You will be responsible for the daily operations supporting these products, working with Customer Success teams. You'll analyze and implement system configurations, maintain documentation, and collaborate with internal partners. This position requires a minimum of a four-year college degree or equivalent experience, along with demonstrated customer service and analytical skills. PDMI offers a collaborative environment, exciting challenges, and the opportunity to work with passionate professionals.

Requirements

• Minimum four-year college degree preferred or equivalent industry (i.e., healthcare or insurance) experience
• Must have prior experience with benefits and compiling analytical data and reports
• Demonstrated customer service skills
• Ability to develop a unique understanding of PDMI brand, products, and services
• Excellent Microsoft Office skills, including Outlook, Teams, Excel, and Word
• Very strong attention to detail
• Excellent organizational and time management skills
• Ability to manage multiple projects and priorities
• Ability to understand and document system logic and processes within our software programs and applications
• Ability to understand and communicate complex concepts in simple terms
• Troubleshooting, analytical, and issue resolution skills
• Excellent research and follow-up skills
• Exceptional written and verbal communication skills
• Ability to interpret client requests and coordinate to accomplish tasks accordingly
• Ability to build and manage effective working relationships

Responsibilities

• Provide analysis and support for implementing new client business and ongoing maintenance of existing client business related to benefit design changes
• Provide analysis, interpretation, integration, and business decisions with regards to system configuration
• Develop and maintain knowledge of both the technical and operational sides of the business utilizing PDMI’s proprietary claims adjudication system and any other applications, including system upgrades and enhancements
• Analyze and implement requests for system configuration with a high degree of accuracy
• Maintain documentation that validates system configuration
• Ensure the accurate management of plan benefits coding changes, test execution and validation efforts of plan benefit design requests
• Work closely with internal partners to support and meet client needs for specific products and projects related to claims adjudication, reporting, accumulators, and eligibility
• Actively engage in project teams and make recommendations regarding process improvements and other business initiatives
• Develop, update, and maintain departmental procedures surrounding specific product lines
• Share knowledge and mentor colleagues in specific product line areas to enhance company-wide knowledge of products and services
• Resolve issues before escalation path transitions outside of department
• Perform quality assurance peer reviews on system configurations with a high degree of accuracy consistent with department work standards
• Contribute towards departmental performance by maintaining service level guarantees and achieving individual performance goals around accuracy and timeliness
• Actively engage in team meetings and provide input for project/issue resolution
• Comply with standards set forth regarding benefit design and configuration including but not limited to Health Insurance Portability and Accountability Act of 1996 (HIPAA) and National Council for Prescription Drug Programs (NCPDP)
• Attend educational summits and/or conferences related to specific product lines

Preferred Qualifications

Background encompassing electronic claims processing

Benefits

Flexible Work: Fully remote opportunity with a company that cares