Benefit Design and System Support Analyst
Company: Southern Scripts
Location: Atlanta
Posted on: October 4, 2024
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Job Description:
Benefit Design and System Support AnalystWe wanted a PBM that
worked better--- so we created one. Liviniti, the leading disruptor
in the PBM industry, simplifies the complexities of navigating
through the Pharmacy Benefit Manager world by offering a
value-added approach to ensure the employer absolute freedom,
control, and choice to their health plan structure without
compromising patient experiences and outcomes. We improve
healthcare and reduce rising prescription costs for employers and
their employees. We are looking for individuals who are passionate,
strong, and committed to developing systems and service solutions
that promote our business goals and commitments.Liviniti is
searching for incredible talent! We continue to experience
accelerated growth in a rapidly changing industry. There's never
been a better time to join our team. We are currently seeking a
Benefit Design and System Support Analyst. This is a remote
position.Role and ResponsibilitiesThe Benefit Design and System
Support Analyst provides Liviniti employees and customers with
comprehensive knowledge of the claim processing system. This
includes answering questions and assisting with problem
resolution.Manages tickets within a ticketing system; troubleshoots
and resolves tickets that are placed in the claims processing
queues in a timely manner. Adjudicates information on multiple
software platforms. Enforces procedures that are put in place by
the Benefit Design Supervisor, Director of Claims Processing, and
other Leadership. Identifies and corrects Benefit Design errors
within the claims processor based on client documentation. This may
include performing financial audits on the error(s) found and
determining impact for the client and/or Southern Scripts. Provides
and potentially presents audit findings to Account Management and,
on occasion, the Leadership team. Facilitates benefit designs for
new clients within the claims processor based off of
documentation.Communicates with the Implementation team to discuss
and/or ask questions regarding benefit designs for new
clients.Communicates with the EDI team to discuss and/or ask
questions regarding various data files.Communicates with the
Clinical team to discuss and/or ask questions regarding clinical
edits that are active for current clients.Works in conjunction with
the Clinical team to input information into the claims processor
and makes updates based on extensive testing to ensure the clinical
request is to appropriate specifications.Communicates with the
Account Management team to facilitate benefit design updates and
obtain appropriate documentation for current clients.Assists
Customer Service Representatives with troubleshooting and resolving
issues within our claims processor, when appropriate.Works in
conjunction with an external programming team to analyze and
resolve programming error(s) within our claims
processor.Participates in developing additional quality assurance
for internal processes.Plays an active role in evaluating quality
standards from an objective point of view and ensuring the proper
checks and balances are applied to all parts of the Claims
Processing procedures.Abides by all obligations under HIPAA related
to Protected Health Information (PHI).If a HIPAA violation is
discovered, whether individually or by another, reports the
violation to the Compliance Officer and/or Human Resources.Attends,
completes, and demonstrates competency in all required HIPAA
Training offered by the company.Flexibility to understand,
appreciate and embrace that the job description is not designed to
cover or contain a comprehensive listing of activities, duties or
responsibilities that are required of the employee. Duties,
responsibilities and activities may change or new ones may be
assigned at any time with or without notice.What We Have to
OfferOur benefits package is designed to keep our employees happy
and healthy - physically, mentally and financially. Medical,
Dental, Vision insuranceDisability and Life insuranceEmployee
Assistance ProgramGenerous Paid-Time OffAnnual Reviews and
Development PlansRetirement Plan with company match immediately
100% vestedRequired Skills and CompetenciesOrganizationTime
ManagementStrong Problem-Solving SkillsStrong
communication/collaboration skillsEasily adapt to and learn new
technology and skillsThoroughnessSupervisory ResponsibilityThis
position has no supervisory responsibilities.Position Type and
Expected Hours of WorkThis is a full-time salaried position. Days
and hours of work are Monday through Friday; 40+ hours a week, with
occasional after-hours or weekend duties. Position can be remote or
onsite. TravelNo travel expected for this position.Qualifications
and Education RequirementsAssociate or Bachelor's degree
preferred.2 to 3 years' previous experience working in PBM
environment, health plan, pharmacy chain, or managed care services
organization in a Systems or Plan Design capacity.Intermediate or
advanced proficiency with MS Excel, Word, PowerPoint,
OutlookExcellent verbal and written communication skills,
establishing rapport and working with others.Liviniti, LLC provides
equal employment opportunities (EEO) to all employees and
applicants for employment without regard to race, color, religion,
sex, national origin, age, disability or genetics. In addition to
federal law requirements, Liviniti complies with applicable state
and local laws governing nondiscrimination in employment in every
location in which the company has facilities. This policy applies
to all terms and conditions of employment, including recruiting,
hiring, placement, promotion, termination, layoff, recall,
transfer, leaves of absence, compensation and training.Liviniti
expressly prohibits any form of workplace harassment based on race,
color, religion, gender, sexual orientation, gender identity or
expression, national origin, age, genetic information, disability,
or veteran status. Improper interference with the ability of
Liviniti employees to perform their job duties may result in
discipline up to and including discharge. EOE
M/F/V/DPI16d35b7dc61b-25660-35716653
Keywords: Southern Scripts, Redan , Benefit Design and System Support Analyst, Professions , Atlanta, Georgia
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