Business System Analyst (Benefits Systems Administration Analyst)

Description Job Title: Benefits Systems Administration Analyst Department Name: Benefit Systems Solutions & Operations

*Mandatory Screening Questions for all Applicants-Please list Answers on Resume Pre-Screening Questions - Benefit Analyst
1) Please explain the type of health insurance/benefit administrative functions you've performed - and how you have ensured quality.
2) Describe a project you participated in where your attention to detail, planning and organization were critical to success. What was your role? How did you keep track of the tasks? How did you ensure you met the timelines with quality outcomes?
3) Consider times when you did your best work and other times when you didn't. Give me an example of each. What made the difference?

PURPOSE OF POSITION: Candidate will provide analysis to develop, design, implement, maintain and support new/existing product and benefit administration both internally and with external vendors. Maintains knowledge of policies and procedures and performs in accordance with applicable regulatory requirements, external laws and accreditation standards as they relate to Membership/Benefit Administration and Marketing, Sales and Business Development. All Candidates must have Advanced Excel Skills and list Test Scores on bottom of Resume. Background in Healthcare Configuration preferred. Must be very organized and detail orientated.

REQUIRED SKILLS:
Two to four years of work experience with business systems analysis/administration, benefit administration/analysis or product development/management.
Strong detail and quality orientation essential.
Working knowledge of managed care, indemnity insurance, alternate funding, state, and federal regulations.
Claims coding and/or adjudication experience helpful
Excellent interpersonal and communication skills - verbal and written.

TECHNICAL SKILLS:
Proficiency in Microsoft Office Suite, advanced Excel skills preferred

ESSENTIAL RESPONSIBILITIES:
Analyzes and interprets benefit/plan related documentation, to include legislation, and provides recommendations to support and administer new/existing products and benefits considering customer, clinical, pricing and regulatory implications. Documents benefit/plan requirements, creates, implements and maintains benefits/plans to meet regulatory and internal/external benefit administration needs.
Maintains and updates Benefit Administration systems/databases, eg web-based and Legacy systems, with complex detailed benefit information to support products, benefits, membership and contracts.
Helps support end-to-end product/benefit user acceptance testing
Ensures benefit/plan information quality and compliance. Develops and performs quality assurance processes. Knowledgeable in all applicable policies, local, state and federal laws and regulations, and accreditation standards.
Acts as a source-matter expert for benefits. Troubleshoots benefit issues daily and recommends/implements solutions.
Interacts with a wide variety of internal customers to include, but not limited to, Sales, Product Development, Underwriting and Contracts.
Data management through creation of spreadsheets and reports in Microsoft Excel and Access.
Helps design, develop and implement new and improved processes, tools and system enhancements.
Performs Project Lead role for Benefit Administration projects as needed. Creates and manages projects plans.
Prepares training materials and communication updates and conducts training both in a group and one-on-one setting.
Assists with data validation, auditing and user acceptance testing.

Education: Minimum HS Diploma