Benefit Plan Configuration and Client Support Specialist US - IGTPH

Qualifications:

• Graduate of Business Administration, Management, Communication, Healthcare, or any relevant degree
• At least 2 years of experience in pharmacy benefit management, healthcare data, and/or client services area
• Experience with the plan build/plan configuration of the claim adjudication platform
• Experience with commercial health plan design
• Experience with project methodology (requirements, design, development, testing, and implementation)
• Proficient in MS Office (Word, Excel, PowerPoint, and Outlook)
• Preferably with working experience with RxClaim or SXC
• Exceptional organizational skills with the ability to prioritize tasks, meet deadlines, and handle multiple responsibilities simultaneously
• Strong written and verbal communication skills, ensuring clear and professional interactions with clients and internal teams
• Must be willing to work on-site at least 1x a week
• Ability to work from 9:00 pm to 6:00 am PHT

Responsibilities:

• Execute the build and implementation of benefit plan adjudication rules
• Coordinate the integration or conversion of new clients and/or products as needed, often under aggressive timelines
• Establish consistency and standardization as it relates to tools and processes (deliverable templates, change management processes, business models, process flows, etc.)
• Ability to execute testing to ensure the accurate configuration of business requirements
• Analyze larger sets of claims data to evaluate patterns of billing as it relates to benefit design and configuration
• Partner with pharmacies and Client Success Managers to identify and resolve issues related to the plan configuration
• Perform other duties as assigned
• Respond to Tier 1 through Tier 3 telephone and email inquiries
• Quickly and effectively respond and troubleshoot to solve Client challenges
• Communicate appropriate options for resolution in a timely manner
• Gather information, research /resolve inquiries, and log Client calls