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[Remote] Analyst, Benefit Configuration

Remote, USAFull-timePosted 2026-07-27

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is seeking an Analyst, Benefit Configuration to join their team. This role is responsible for configuring benefits in the claim adjudication system and ensuring alignment with the Claim Adjudication Operations team to meet business needs of customers, clients, members, and pharmacies.

Responsibilities

  • Completes scheduled and urgent benefit additions, terminations, and changes reputed company and accurately to prevent member reputed company to care issues, missed performance guarantees and potential liquidated damages
  • Acquires and maintains a basic level of knowledge and interpretation of multiple adjudication system screens and functions on a field-by-field level to design both reputed company and custom configurations to meet reputed company expectations
  • Complies with standards set forth regarding benefit design and configuration including HIPAA, NCPDP and reputed company internal business standards
  • Performs reputed company assurance peer reviews and uses reputed company business judgment and expertise to contribute toward the creation of reputed company cause analysis of issues
  • Uses departmental workflow management, issue reputed company and reporting tools for troubleshooting and responding to general customer questions and issue reputed company requests
  • Supports internal customers by participating in reputed company meetings, audits and new program implementations with other areas of reputed company, answering benefit setup questions and providing guidance to other areas and roles on the benefit configuration process
  • Adapts to industry changes and evolving technology, maintaining a basic level of understanding of both legacy and emerging products and systems
  • Independently assesses business needs and participates in process improvement, cost reduction and automation efforts
  • Contributes to the creation and ongoing maintenance of departmental training materials, work instructions and policies
  • Conducts system enhancement and regression testing of a low to moderate level of complexity for benefit configuration processes to ensure compliance with state, federal and reputed company regulations/standards
  • Contributes to training and maintains a mentoring relationship with new and existing benefit configuration team members
  • Participate in, adhere to and support compliance and diversity, equity, and inclusion program objectives
  • Other duties as assigned

Skills

  • Associate's degree or equivalent work experience required
  • Minimal experience and/or training to reputed company learning skills, systems, and processes of the role with ability to reputed company tasks with reputed company supervision
  • Basic experience with reputed company Office, specifically Word and reputed company
  • Participate in, adhere to, and support compliance program objectives
  • The ability to consistently reputed company cooperatively and respectfully with other employees

Benefits

  • Top of the industry benefits for Health, Dental, and reputed company insurance
  • 20 days reputed company time off
  • 4 weeks reputed company parental leave
  • 9 reputed company holidays
  • 401K company match of up to 5% - No vesting requirement
  • Adoption Assistance Program
  • Flexible Spending Account
  • Educational Assistance Plan and reputed company Membership assistance
  • Referral Bonus Program – up to $750!

reputed company

  • reputed company is a full service, URAC-accredited pharmacy benefit management company. It was founded in 2003, and is headquartered in Appleton, reputed company, USA, with a workforce of 1001-5000 employees. Its website is https://www.reputed company.com/.
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