Senior Benefits Configuration Tester

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🕒 Julho 10

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SmithRx

SiteLinkedInTodas as Vagas

51 - 200 funcionários

Fundada em 2018

💼 Consultoria

🛡️ Seguros

🏥 Saúde

💰 $20.000.000 Series B em 2022-03

Consulting • Insurance • Healthcare

A SmithRx é uma gestora de benefícios farmacêuticos transparente e direta, que opera de forma independente de companhias de seguro e farmácias para alinhar seus incentivos com empregadores auto-segurados e seus membros. Ao aproveitar a tecnologia moderna, a SmithRx busca reduzir o custo e a complexidade dos benefícios farmacêuticos, garantindo a entrega de medicamentos eficazes e de baixo custo. A empresa está dedicada a transformar o cenário dos benefícios farmacêuticos através de seu modelo de precificação transparente e de taxa fixa e programas inovadores de economia de custos, que conectam os membros aos medicamentos de menor custo sem o uso de precificação diluída, descontos ou outras táticas. O compromisso da SmithRx com a transparência e um serviço ao cliente superior resulta em economias significativas para empregadores e uma experiência altamente satisfatória para seus membros.

Descrição

• Organize testing suites, create test plans, and submit moderately difficult test cases to validate the accuracy of complex benefit configuration setups. • Serve as a key liaison with senior members of the Benefit Operations team, actively communicating to resolve configuration discrepancies, clarify plan designs, and report actionable insights back to the testing team. • Provide support, guidance, and peer review for junior team members to ensure testing accuracy, helping them understand SmithRx claims adjudication systems and upstream/downstream processes. • Handle Advanced Logic Validation such as Clinical/Prior Authorization and Financial Accumulators. Ensuring patient out-of-pocket maximums and cost-shares remain accurate. • Document detailed defect reports for issues uncovered during testing and assist in the development of process improvements focusing on efficiency and accuracy.

🎯 Requisitos

• Minimum of 2 - 4 years of related experience in benefits configuration or testing in healthcare. PBM or managed care experience is preferred but not required. • Associate degree or equivalent work experience is required. • Strong understanding of benefit design standards, including HIPAA, NCPDP, and SmithRx internal business standards, alongside moderate skills in Microsoft Excel. • Ability to work with little instruction on daily work, relying on general instructions only for newly introduced assignments. • Strong critical thinking skills, such as analyzing data, drawing logical conclusions, and applying smart solutions to moderately difficult situations. • Communicate effectively (written, verbal/presentation, and active listening) to successfully act as a liaison and collaborate cross-functionally.

🏖️ Benefícios

• Highly competitive wellness benefits including Medical, Pharmacy, Dental and Vision Insurance. SmithRx pays up to 90% for you and your family. • Fully paid Life insurance and Disability benefits • 3 weeks PTO • 401(k) Retirement Savings Program • Flexible Spending Benefits • Generous Paid Parental Leave benefits • Professional development, training and career growth opportunities • Well-stocked kitchen