At least 4+ years of experience in payer/claims and benefit configuration required.
Analytical skills; Microsoft Excel skills are needed.
Strong communication skills via face-to-face meetings, conference calls, and written correspondence is necessary.
Self-starter mentality: ability to make informed decisions, find creative approaches to difficult challenges, and deliver on commitments.
Responsibilities
Work with clients, identifying and understanding benefit plan requirements. Build and maintain pharmacy benefit plans for client groups.
Aid in the organization of benefit configuration and structure for the accounts assigned by monitoring plan data integrity.
Assist in determining process improvement efforts.
Maintain prior authorizations and step therapy rules.
Grandfather/transition new clients and update formularies with changes at the direction of the clinical team.
Communicate project status, escalating issues when appropriate. Provide insight into changes to improve workflow efficiency.
Collaborate with member support and customer success teams to review and resolve inquiries related to benefits timely to improve member experience.
Provide troubleshooting support for our claims adjudication process.
Support new client implementations, conduct go-live testing, perform post go-live auditing and support to ensure plans are configured to confirm accuracy.
4+ years of experience in payer/claims and benefit configuration required.
Analytical skills; Microsoft Excel skills;
Strong communication skills via face-to-face meetings, conference calls and written correspondence.
Self-starter mentality: ability to make informed decisions, find creative approaches to difficult challenges, and deliver on commitments.
Execution-focused ethos - you are a solutions-oriented problem solver and efficiency driven.
Flexible, dependable, adaptable, and able to respond under the pressure of a fast-paced technology company.
What SmithRx Offers You:
Highly competitive wellness benefits including Medical, Pharmacy, Dental, Vision, and Life Insurance and AD&D Insurance
Flexible Spending Benefits
401(k) Retirement Savings Program
Short-term and long-term disability
Discretionary Paid Time Off
Paid Company Holidays
Wellness Benefits
Commuter Benefits
Paid Parental Leave benefits
Employee Assistance Program (EAP)
Well-stocked kitchen in office locations
Professional development and training opportunities