Job Description
osition Summary
We are seeking a Benefits Configuration Specialist (PBM) to join our team. This role is responsible for configuring and maintaining pharmacy benefit plans, business rules, rates, and provider networks within the claims adjudication system. The ideal candidate will ensure configuration accuracy through testing and quality assurance while supporting client implementations, system demonstrations, and cross-functional initiatives.
Key Responsibilities
Configure and maintain pharmacy benefit plans, business rules, rates, and networks in the claims adjudication system.
Validate system configurations by entering and testing claims.
Perform quality assurance reviews to ensure configuration accuracy.
Support User Acceptance Testing (UAT) by developing and executing test scenarios and documenting results.
Research and resolve benefit configuration and claims processing inquiries.
Provide configuration support and consultation to intern...