Benefit Configuration Analyst I

Job Description:

$15.99 + DOE; Work from home!

The Benefit Configuration Analyst I position is an entry level position for Plan Build. A Benefit Configuration Analyst I is responsible for successfully maintaining the benefits of Level I 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

• Successfully complete Plan Build training program within 6 months
• Maintain system benefit configuration for Level I clients
• Regularly update and maintain tables essential for claims adjudication i.e. PDCRM, ACNM, AAPM, AC, CFEEM, and many more.
• Clearly understand plan documentation (Summary Plan Descriptions, change forms, emails, etc.)
• Maintain organized information on training, assigned group’s special characteristics, etc.
• Ability to work efficiently, multi-task, prioritize tasks, and meet tight deadlines
• Identify and expedite issue resolution regarding plan design and interpretation of benefits to appropriate management personnel, with assistance from Configuration Analyst III, Technical Specialist or Team Lead. Respond to 1st and 2nd level-escalation claim issues within 24-48 hours. 
• Work route QUE daily, adherence to 24-48-hour turnaround. 
• Aid Benefit Configuration Analysts II and III in plan implementation with key departments such as Administration, Claims, Customer Care, and Account Management.
• Maintain a positive and flexible attitude
• Be a strong team player
• Be dependable, reliable and maintain high team standards
• Be self-motivated

Additional

• Performs other related duties as assigned or needed.

Experience and Skills:

• 2 years’ experience in Claims Adjudication, Group Benefits, Provider Update, and Customer Care systems or related claims-related processes required.
• Claims processing, coding and/or customer service experience for a minimum of one year in the TPA business
• Knowledge of CPT, diagnosis, HCPC, and UB92 revenue coding
• Ability to use technical experience to make decisions regarding plan changes.
• Ability to read and understand plan benefits
• Knowledge of Microsoft Office and other computer programs/software
• Requires interpersonal skills to relate to clients and other departments within the company
• 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 not yet hiring in the below states:

• Alabama Delaware Massachusetts Mississippi Montana New Hampshire New Jersey New Mexico New York North Dakota Rhode Island South Dakota Vermont

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.