Healthcare Benefit Analyst
Current- Analyze and resolve benefit coding and claims processing inquiries, resulting in a 20% reduction in turnaround time for client responses.- Implement timely updates based on QA feedback, maintaining a 98% accuracy rate in claims processing.- Develop and implement new pharmacy benefit plan designs in RxClaim, enhancing system functionality and client satisfaction.- Lead system testing and monitoring initiatives, ensuring optimal system capabilities and accuracy in claims processing.- Provide expert support for the Benefit Edit Tool (BET) submissions, improving client engagement and operational efficiency.- Utilize advanced Excel functions to create and optimize plan build checklists and macros, streamlining drug list integration and enhancing data readability.- Execute comprehensive reports and queries to conduct detailed plan analysis, driving data-driven decision-making for process improvements.