Benefits Setup Representative Senior

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    "description": "Job DescriptionThe Client Benefit Representative III will analyze client benefit requests, determine best operational approach and perform coding. This employee will also validate coding accuracy utilizing various tools to ensure no financial impact or client/participant dissatisfaction. The Client Benefit Representative III will be responsible for meeting or exceeding turnaround time and quality standards as well as researching client benefit requests/issues and recommending alternative solutions to internal partners in meeting client needs. In addition to coding, this position will also be responsible performing QA functions such as moving all plan design implementations and/or changes into a Production status upon completion of a review within tight timelines. This position may support coding, testing and QA activities for commercial clients as well as clients with federal/state programs (such as Medicare D, Medicaid, MAPD, RDS, COB, EGWP, HealthCare Reform, etc.)Required Qualifications- 2 + years experience within a Healthcare, PBM or Pharmacy environment- 2+ years experience with AS400/RXclaimPreferred QualificationsPrevious coding experienceBachelor's degree in any discipline is preferredEducationHigh School Diploma or GED requiredBusiness OverviewIts a new day in health care.Combining DM Health and Aetna was a transformative moment for our company and our industry, establishing DM Health as the nations premier health innovation company. Through our health services, insurance plans and community pharmacists, were pioneering a bold new approach to total health. As a DM Health colleague, youll be at the center of it all.At DM Health, we work every day to help people on their path to better health. Never has it been more important for us to deliver on our purpose to our valued customers, patients, members, and employees. With a presence in communities across the country, DM Health colleagues are and will continue to be a critical piece of the countrys health care solution. The health and safety of our employees, patients, customers, and members is our top priority as we face the impact of COVID-19 together. If you would like to learn about the actions we are taking as a company as we learn more about COVID-19 and its spread, we encourage you to visit our COVID-19 resource center at https://DMhealth.com/covid-19We offer a diverse work experience that empowers colleagues for career success. In addition to skill and experience, we also seek to attract and retain colleagues whose beliefs and behaviors are in alignment with our core values of collaboration, innovation, caring, integrity and accountability.DM Health is an equal opportunity/affirmative action employer. Gender/Ethnicity/Disability/Protected Veteran  we highly value and are committed to all forms of diversity in the workplace. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for DM Health job opportunities. We comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW and EEO IS THE LAW SUPPLEMENT. Please note that we only accept applications for employment via this site.We provide reasonable accommodations to qualified individuals with disabilities. If you need to request an accommodation, a qualified interpreter, written information in other formats, translation or other services, please contact our Advice and Counsel Reasonable Accommodations team by emailing Advice and Counsel Reasonable Accommodations team",
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---
type: 'JobPosting'
title: 'Benefits Setup Representative Senior'
url: 'https://pepper2.socialhost.dev/job/11124311/benefits-setup-representative-senior/'
job_id: '11124311'
organization: 'SFX Demo'
location: 'Salt Lake City, UT'
date_posted: '2020-06-24T17:03:50.957Z'
date_modified: '2020-09-22T16:03:02.443Z'
---

# Benefits Setup Representative Senior

- Location: Salt Lake City, UT
- Category: Customer Service
- Pay: not listed — this posting doesn’t list a range yet. Your recruiter can share it before you apply.
- Organization: SFX Demo
- Posted: 2020-06-24T17:03:50.957Z

## Description

Job Description
The Client Benefit Representative III will analyze client benefit requests, determine best operational approach and perform coding. This employee will also validate coding accuracy utilizing various tools to ensure no financial impact or client/participant dissatisfaction. The Client Benefit Representative III will be responsible for meeting or exceeding turnaround time and quality standards as well as researching client benefit requests/issues and recommending alternative solutions to internal partners in meeting client needs. In addition to coding, this position will also be responsible performing QA functions such as moving all plan design implementations and/or changes into a Production status upon completion of a review within tight timelines. This position may support coding, testing and QA activities for commercial clients as well as clients with federal/state programs (such as Medicare D, Medicaid, MAPD, RDS, COB, EGWP, HealthCare Reform, etc.)
Required Qualifications
- 2 + years experience within a Healthcare, PBM or Pharmacy environment
- 2+ years experience with AS400/RXclaim
Preferred Qualifications
Previous coding experience
…

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