Benefit Design and System Support Analyst
Company: Southern Scripts
Posted on: September 22, 2022
Benefit Design and System Support Analyst - remote/work from
We wanted a PBM that worked better--- so we created one.
Southern Scripts , 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
Southern Scripts 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 fully remote/work from home position.
Role and Responsibilities The Benefit Design and System Support
Analyst provides Southern Scripts employees and customers with
comprehensive knowledge of the claim processing system. This
includes answering questions and assisting with problem
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
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
Communicates with the Account Management team to facilitate benefit
design updates and obtain appropriate documentation for current
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
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
If a HIPAA violation is discovered, whether individually or by
another, reports the violation to the Compliance Officer and/or
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 Offer
Our benefits package is designed to keep our employees happy and
healthy - physically, mentally and financially.
Medical, Dental, Vision insurance
Disability and Life insurance
Employee Assistance Program
Remote work options
Generous Paid-Time Off
Annual Reviews and Development Plans
Retirement Plan with company match immediately 100% vested
Required Skills and Competencies Organization
Strong Problem-Solving Skills
Strong communication/collaboration skills
Easily adapt to and learn new technology and skills
This position has no supervisory responsibilities.
Position Type and Expected Hours of Work This 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.
Travel No travel expected for this position.
Qualifications and Education Requirements
Associate 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,
Excellent verbal and written communication skills, establishing
rapport and working with others.
Preferred Qualifications SQL experience
Southern Scripts, 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, Southern Scripts
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.
Southern Scripts 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 Southern Scripts employees to
perform their job duties may result in discipline up to and
including discharge. EOE M/F/V/D
Keywords: Southern Scripts, Shreveport , Benefit Design and System Support Analyst, Professions , Natchitoches, Louisiana
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