Benefit Plan Configuration Specialist - Plan Build

📋 Description

• Create the blueprint for configuration of the plan from plan documents and/or plan standards.
• Build, validate and test medical and dental plan benefits and associated code mapping logic.
• Make necessary plan building and logic revisions when plans are amended.
• Build auto-adjudication logic and test for integration with plan.
• Resolve system issues and act as contact for opening and closing jobs on the core claims platform
• Test open jobs on new releases from the core claims platform and troubleshoot problems prior to

🎯 Requirements

• Knowledge of professional and institutional claims adjudication.
• Ability to interpret plan documents and amendments and translate benefits to ICD 10, HCPCS, CPT
• Exemplary customer service skills demonstrated by researching and resolving issues that are
• Ability to adapt to a constantly changing environment.
• Demonstrated organizational skills and ability to work independently, problem-solve, and make
• Demonstrated ability to work in a fast-paced, agile environment managing multiple issues with

🎁 Benefits

• Remote or hybrid work
• Offers Equity
• Offers Bonus
• Hourly salary range: $30.29 – $35.10