Benefit Configuration Analyst II

Job Description:

The Benefit Configuration Analyst II is responsible for successfully maintaining the benefits of Level II groups in the GBAS operating system. He or she is the expert on how these groups’ benefits are configured in GBAS, as well as EOBs, Accumulators and Provider Contract Assignments/check formats. They are a resource to various teams across the company (i.e., Claims, Account Management, Customer Care, Client Accounting) regarding how the system is configured to facilitate plan based GBAS functions. 

Key Result Areas

Essential

• Independently administer plan benefits based on documentation received, for Level II groups
• Regularly update and maintain tables essential for claims adjudication i.e., PDCRM, ACNM, AAPM, AC, CFEEM, and many more. Assist Configuration Analyst I on updates.
• Shadow Benefit Configuration Analyst III, Technical Specialist or Team Lead in plan implementations, with key departments such as Administration, Claims, Customer Care, and Account Management.
• Play an active role in plan administration by providing technical support for multiple departments. Assist others in reviewing potential options for plan configuration.
• Identify and expedite issue resolution regarding plan design and interpretation of benefits to appropriate management personnel. Respond to 1st and 2nd level-escalation claim issues within 24-48 hours. 
• Independently work claim route QUE daily with adherence to 24-48-hour turnaround.  
• Perform basic audits for Level I groups’ plan changes.  
• Support AmeriBen Culture
• Maintain a positive and flexible attitude.
• Be a strong team player.
• Be dependable, reliable and maintain high team standards.
• Be self-motivated.

Additional

• Ability to identify problems with Plan set-up.
• Performs other related duties as assigned or needed.

Experience and Skills:

• Experience as Benefit Configuration Analyst I or extensive experience in Claims Processing along with GBAS functionality is required.
• 3 years’ experience in Claims Adjudication, Provider Update, Customer Care or other claims-related processes.
• Knowledge of CPT, diagnosis, HCPC, and UB92 revenue coding and ability to use technical experience to make decisions regarding plan benefits.
• Ability to read and understand plan documents.
• Ability to work efficiently, multi-task, prioritize tasks, and meet tight deadlines.
• Interpersonal skills to relate to clients, vendors and other departments within the company is required.
• Ability to efficiently and effectively perform the Essential Key Result Areas with or without a reasonable accommodation without posing a direct safety threat to others or self.
• Protect and enhance the Core Purpose and the Core Values of the AmeriBen/IEC Group

AmeriBen is an Equal Opportunity Employer committed to creating an environment of diversity and inclusion for equal employment and advancement opportunities to all employees and applicants for employment. All qualified applicants will receive consideration for employment without regard to race, religion, color, age, national origin, sex, sexual orientation, gender identity and/or expression, genetic information, disability, veteran or military status, or any other category protected by federal, state and/or local law.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. If you are unable to use our online application process due to a disability, please contact the Human Resources Department at humanresources@ameriben.com or call 208-488-7654.