Ben Admin Quality Analyst
- Frisco, TX
What you'll be doing
- Work with cross functional teams to suggest, implement and document process improvements. Responsible for meeting turnaround times, quality measurements and performance guarantees. Follows all policies and procedures relating to job function. Analyze client documentation against system set up to identify defects. Utilize both manual and automated testing processes to determine accuracy of benefit coding. Reporting defects identified during testing to appropriate departments consistently until resolved. Effective in the utilization in various aspects of quality excellence including; software, tools, procedures, best practices etc. Performs other duties as assigned to meet corporate initiatives. Travel as needed.
What your background should be
- Minimum of 2 years of quality and or argus/rxclaim coding experience. Minimum of 1 year experience in the pharmacy benefit management (PBM) industry. Knowledgeable in prescription benefit set up and adjudication rules in AS400/rxclaim platform. Must possess strong organizational and analytical skills to review claims data and audit against plan specifications. Must be able to meet tight deadlines in a fast-paced environment. Must have the ability to analyze data, determine conclusions, document results and communicate outcomes. Experience with medicare part D set up a plus. Experience in automation and query tools required.
Required Schooling / Training
- High school diploma required. College level education is a plus.
Who is the client company
- Concern about hospital & health care services.
- If you are interested in this position, send your resume to email@example.com