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SmithRx

Senior Benefits Configuration Tester

RemoteUnited States onlyArchived
Published
Role
QA
Experience
Senior
Company size
Startup
Salary not disclosed
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Open to US only. Set where you work from to check your eligibility.

No BS summary

Senior benefits configuration tester with 2–4 years in healthcare benefits configuration or testing. Needs benefit design knowledge, HIPAA/NCPDP familiarity, Microsoft Excel, and strong communication for cross-functional liaison work. PBM or managed care experience is preferred.

Required skills

Microsoft Excel

What you'll do

  • Organize testing suites, create test plans, and submit moderately difficult test cases to validate the accuracy of complex benefit configuration setups.
  • Serve as a key liaison with senior members of the Benefit Operations team, actively communicating to resolve configuration discrepancies, clarify plan designs, and report actionable insights back to the testing team.
  • Provide support, guidance, and peer review for junior team members to ensure testing accuracy, helping them understand SmithRx claims adjudication systems and upstream/downstream processes.
  • Handle Advanced Logic Validation such as Clinical/Prior Authorization and Financial Accumulators.
  • Ensuring patient out-of-pocket maximums and cost-shares remain accurate.
  • Document detailed defect reports for issues uncovered during testing and assist in the development of process improvements focusing on efficiency and accuracy.

What they require

  • Minimum of 2 - 4 years of related experience in benefits configuration or testing in healthcare.
  • Preferred: PBM or managed care experience is preferred but not required.
  • Associate degree or equivalent work experience is required.
  • Strong understanding of benefit design standards, including HIPAA, NCPDP, and SmithRx internal business standards, alongside moderate skills in Microsoft Excel.
  • Ability to work with little instruction on daily work, relying on general instructions only for newly introduced assignments.
  • Strong critical thinking skills, such as analyzing data, drawing logical conclusions, and applying smart solutions to moderately difficult situations.
  • Communicate effectively (written, verbal/presentation, and active listening) to successfully act as a liaison and collaborate cross-functionally.

Benefits

  • Highly competitive wellness benefits including Medical, Pharmacy, Dental and Vision Insurance.
  • SmithRx pays up to 90% for you and your family.
  • Fully paid Life insurance and Disability benefits
  • 3 weeks PTO
  • 401(k) Retirement Savings Program
  • Flexible Spending Benefits
  • Generous Paid Parental Leave benefits
  • Professional development, training and career growth opportunities
  • Well-stocked kitchen
  • This role may be eligible for bonuses, commissions, or equity.
  • Time off programs
  • Mental health support

The Customer Success Team at SmithRx is dedicated to helping clients and partners derive maximum value from Pharmacy Benefit Management (PBM) services.

🇺🇸 United StatesHealthcareStartup

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Salary not disclosed