Assist with the identification and implementation of solutions which result in efficient, accurate, and quality configuration and maintenance of the systems used with our FSA/HRA and COBRA products. Consult with operational areas to assist with the identification, selection, and modeling of solutions to meet operations-identified needs, goals, and metrics. Ensure the timely configuration and implementation of selected solutions either by directly completing the solution or providing specifications and/or instructions for completion of the solution. Accountable for complying with all laws and regulations that are associated with assigned duties and responsibilities.
1. Configure FSA/HRA and COBRA CRM applications.
2. Accurately and reliably maintain, document, and test configuration.
3. Understand core business functions at a fundamental level.
4. Analyze existing and proposed business requirements and define configuration options.
5. Ensure cross-functional impacts are considered when adding or modifying application configuration.
6. Document system configuration approaches. Assist in the definition of costs and benefits of proposed solutions.
7. Diagnose and resolve system configuration problems.
8. Perform system upgrade QA testing.
9. Perform accurate and complete data extraction from data warehouse to meet project requirements.
10. Suspend Debit Cards.
11. Create satisfaction survey mailing and send to Service Center.
12. Create and send eligibility file to ScanOne.
13. Assist Production Support Team Lead in report building in Crystal Report as needed.
14. Process Help Desk tickets daily. Assures that client plan changes and member account changes are made within standards, regulations and existing laws for quality, compliance and production.
15. Create and send the Positive Pay file to the PS Finance Dept daily.
16. Roll unused Transportation and HRA balances on Member accounts.
1. Participate in special projects and committees.
2. Support quality improvement initiatives.
3. Meet department and company performance and attendance expectations.
5. Perform other duties as assigned.
Work Experience: Minimum 1 to 2 years of business analysis or relevant experience in health plan environments. 1 year of PayDirect configuration experience preferred.
Education, Certificates, Licenses: BS/BA or equivalent work experience.
Knowledge: Strong knowledge of benefits administration and other healthcare concepts. Experience with relevant tools such as MS Excel and MS SQL Query Analyzer. Experience working in teams. Ability to clearly communicate in person and is able to request and exchange information in a pleasant, respectful and professional manner. Able to prioritize work and perform detailed analytical work under time pressures.
• Building Customer Loyalty
• Building Strategic Work Relationships
• Contributing to Team Success
• Planning and Organizing
• Continuous Improvement
• Building Trust
• Work Standards
• We are committed to doing the right thing.
• We are one team working toward a common goal.
• We are each responsible for customer service.
• We practice open communication at all levels of the company to foster individual, team and company growth.
• We actively participate in efforts to improve our many communities-internally and externally.
• We encourage creativity, innovation, and the pursuit of excellence.
Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately less than 5% of the time.
Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively.
Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.
PacificSource is an equal opportunity and affirmative action employer.
PacificSource Health Plans is anything but a typical health plan. We’re a growing, independent, not-for-profit organization with a...