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Job type full-time
Not provided by employer
Full job description
Join our team: do meaningful work and improve people’s lives
Our purpose, to improve customers’ lives by making healthcare work better, is far from ordinaryAnd so are our employeesWorking at premera means you have the opportunity to drive real change by transforming healthcare.
To better serve our customers, we’re creating a culture that promotes employee growth, collaborative innovation, and inspired leadershipWe are committed to creating an environment where employees can do their best work and where best-in-class talent comes, stays, and thrives! covid-19 vaccination policy: to learn more about our covid-19 vaccination and accommodation requirements, please visit our careers landing pageThe product configuration analyst, senior is responsible to build and configure group product selections within the appropriate systemsThey provide solutions for standard and non-standard benefit configuration as well as implementation for standard and non-standard product selections by small, mid-market and large employer groups and the individual marketThey are required to develop a thorough understanding of the benefit selection from sales and then apply that to the configuration of the system’s product components such as the administrative rules, eob rules, claims processing rules, provider network identification, utilization management rules and detailed benefit administration rulesAccurate and timely configuration of benefits is the key component in ensuring that customers can access their benefits including customer service, pharmacy and claims processingWhat you will do:
Utilize source documents to analyze and then configure standard and non-standard products and benefit provisions for small, mid-market and large employer groups and the individual market
Analyze and interpret the product selection and product changes, determine the gap between standard and custom benefits, consider system constraints and propose alternate solutions
Identify clarifications needed and inconsistent or incomplete product documents and gather information needed to ensure appropriate configuration of those elements
Configure the product “shell”, product components, benefit summary details, accumulators, and existing language for the benefit quoting tool to ensure the timely generation of id cards, payment of medical, dental, and pharmacy claims, and tools for quoting benefits on multiple platforms (customer service, on-line portals, etc.)
Work with sales and operations to identify appropriate application of system restraints and considerations and request clarifications on product intent when needed.
Analyze system generated reports to identify appropriate configuration updates
Provide timely and consistent status updates to all stakeholders and workgroups to ensure a smooth and efficient process for new and renewing groups
Participate in group implementation meetings to identify changes and provide knowledge for current product configuration
Provide support and analysis to retro-product updates and to ensure timely completion and movement into production
Research and respond to inquiries from other departments regarding benefit administration
Participate in project work and other duties on behalf of product configuration
Perform other duties as assigned
What you will bring:
Associate’s degree in a related field such as information systems, business administration, or two (2) years’ professional work experience (required)
Three (3) years work experience in claims, customer service, membership and billing, quality audit, product configuration or similar area (required)
Experience or training using premera systems or equivalent (required)
Good working knowledge of health insurance products, provisions and terminology
Advanced experience in excel or access
Prior health care experience
What we offer
Medical, vision and dental coverage
Life and disability insurance
Retirement programs (401k employer match and pension plan)
Wellness incentives, onsite services, a discount program and more
Tuition assistance for undergraduate and graduate degrees
Generous paid time off to reenergize
Free parking
Equal employment opportunity/affirmative action: premera is an equal opportunity/affirmative action employerPremera seeks to attract and retain the most qualified individuals without regard to race, color, religion, sex, national origin, age, disability, marital status, veteran status, gender or gender identity, sexual orientation, genetic information or any other protected characteristic under applicable lawIf you need an accommodation to apply online for positions at premera, please contact premera human resources via email at careers@premera.com or via phone at 425-918-4785.
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Posted 10 days ago
