Benefit Plan Configuration Administrator II

Maryland Heights MO 63043 St Louis 1 14100 Magellan Plaza

Job Description

Responsible for accurately configuring benefits in the claims payment systems. Identifies benefit configuration issues while working with other team members throughout Magellan, ensuring plan benefits are configured based on customer and regulatory requirements.
  • Analyzes new business plans and/or changes to existing business plans in order to establish the appropriate structure required for claims payments, reporting, etc.
  • Configures the appropriate benefits into the claims system from information received from configuration analysts using both manual and automated procedures, ensuring that benefits are loaded in a consistent manner across all plans.
  • Maintains customer documentation which validates configuration.
  • Assists with mentoring and training team members as needed.
  • Efficient and effective distribution of tasks, using clear and concise instructions and expectations.
  • Prepares updates and reports, including those required for internal and SOX audits.
  • Provides input on specifications related to system changes and/or enhancements. 
  • Serves as the primary contact for both internal and external customers regarding benefit plan configuration.
  • Works closely with IT claims system staff to develop product design and changes through enhancements, ensuring they adequately meet claims processing needs.  -Oversees configuration and testing of system enhancements.
  • Works with testing team to research any discrepancies identified with regression and release testing for system enhancements and/or benefit plans.
  • Assists in the development of process improvements.
  • Other duties as assigned by management.

General Job Information

Title

Benefit Plan Configuration Administrator II

Grade

20

Job Family

Operations Group

Country

United States of America

FLSA Status

United States of America (Exempt)

Recruiting Start Date

10/10/2019

Date Requisition Created

10/9/2019

Work Experience

Healthcare

Education

Bachelors

License and Certifications - Required

License and Certifications - Preferred

Other Job Requirements

Responsibilities

  • Strong working knowledge of Microsoft Office suite, specifically Word and Excel, including running queries and macros.
  • Experience in interpreting and understanding codes/benefits.
  • Experience with claims processing systems and configuring codes/benefits to optimize auto-adjudication.
  • Ability to identify and resolve process and/or systems issues.
  • Strong sense of urgency leading to the timely completion of all projects, training and assignments.         
  • Familiarity with government regulations with ability to operationalize and understand how various aspects of regulation is interdependent and related.

Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply and attest to the security responsibilities and security controls unique to their position.