Benefit Configuration Tester (Healthtech)

TL;DR

Benefit Configuration Tester (Healthtech): Performing configuration testing for new implementations and maintenance changes within a Pharmacy Benefit Management platform with an accent on claims adjudication and benefit design. Focus on creating test suites, executing batch testing, and ensuring compliance with HIPAA and NCPDP standards.

Location: Remote for candidates in AZ, AR, FL, GA, KS, MO, OH, TN, TX, UT, VA, WI or onsite in Lehi, UT or Plano, TX.

Company

A venture-backed Health-Tech company disrupting the Pharmacy Benefit Management (PBM) sector by building a next-generation drug acquisition platform.

What you will do

• Organize testing suites based on requirements and plan designs.
• Create test plans and documentation, and execute batch testing for assigned projects.
• Analyze hirify.global claims adjudication systems and upstream/downstream processes.
• Ensure compliance with HIPAA, NCPDP, and internal business standards.
• Collaborate with cross-functional teams for issue resolution and utilize company reporting tools.
• Develop process improvements to enhance operational efficiency and accuracy.

Requirements

• Associate degree or equivalent work experience.
• At least 2 years of experience in claims processing, healthcare benefits, pharmacy benefits, or commercial health insurance.
• Must be based in one of the following states: AZ, AR, FL, GA, KS, MO, OH, TN, TX, UT, VA, WI.
• Moderate proficiency in Microsoft Excel.
• Strong analytical, problem-solving, and interpersonal communication skills.
• Impeccable attention to detail and accuracy in work product.

Nice to have

• Experience in PBM or managed care.
• Previous professional testing experience.

Culture & Benefits

• Medical, Pharmacy, Dental, and Vision Insurance (company pays up to 90%).
• 401(k) Retirement Savings Program and Flexible Spending Benefits.
• 3 weeks of PTO and generous Paid Parental Leave.
• Fully paid Life insurance and Disability benefits.
• Professional development, training, and career growth opportunities.