Senior Benefits Configuration Tester

Job not on LinkedIn

🔥 0 minutes ago

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

SmithRx

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 2018

⚕️ Healthcare Insurance

☁️ SaaS

🤝 B2B

💰 $20M Series B on 2022-03

Healthcare Insurance • SaaS • B2B

SmithRx is a transparent, pass-through pharmacy benefits manager (PBM) that operates independently from insurance companies and pharmacies to align its incentives with self-insured employers and their members. By leveraging modern technology, SmithRx aims to reduce the cost and complexity of pharmacy benefits, ensuring the delivery of effective and low-cost drugs. The company is dedicated to transforming the pharmacy benefits landscape through its flat-rate, transparent pricing model and innovative cost savings programs, which connect members to the lowest cost drugs without the use of spread pricing, rebates, or other tactics. SmithRx's commitment to transparency and superior customer service results in significant savings for employers and a highly satisfactory experience for its members.

📋 Description

• 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.

🎯 Requirements

• 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.

🏖️ Benefits

• 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