BENEFIT ANALYST

Implementsystematic benefit building, which supports adjudication of claims inaccordance with clients’ benefit summary, plan document and requestedrequirements.? Serves as a team resource for training and mentor to others onthe team.?

Functions:
Client facing role, consult with brokers and clients on the “right” way to set up plan/benefit information Serve as a SME for internal and external partners Analyze a variety of health benefits; including major medical, PPO, dental, disability and vision and if necessary Flex. Complete, maintain and distribute benefit information for each plan change or new client installation. Develop, implement, test and insure accuracy of benefit building for clients in accordance with provisions in the benefit information and plan document ensuring maximum claim productivity and automation. Maintain all required documentation. Handle File Referrals/Discrepancies Support I.T.projects and assist with testing as needed for new system releases Work with implementation team as needed as well as account management to ensure that new and existing clients plan design are built properly Complete Plan changes on existing clients, including any other set up that might be required. ( PPO setup, EDI setup) Support all automation efforts of the enterprise Other duties as assigned Qualifications:

Undergrad college degree strongly preferred, with equivalent years of experience otherwise. Minimum three years health claims experience with a variety of health plans. Full understanding of benefit payment levels, PPO’s, claims processing practices and claim systems. Must have excellent analytical, problem solvingand interpersonal skills. Regularinteraction with various levels of divisional staff