Benefit Configuration Specialist

hace 2 semanas

Guaynabo, Guaynabo, Puerto Rico Appleone A tiempo completo

Job Title: Benefit Configuration Specialist

About the Role: We are seeking a highly skilled Benefit Configuration Specialist to join our team at Appleone. The ideal candidate will have a strong understanding of business rules and be able to set up and test claims in our adjudication system.

Key Responsibilities:

  • Setting up business rules in the adjudication system
  • Testing claims and performing quality assurance reviews
  • Ensuring desired results and accuracy
  • Analyzing and interpreting common Pharmacy Benefit terminology

Requirements:

  • Pharmacy Technician Associate Degree or equivalent
  • Preferred Puerto Rico Board of Pharmacy Technician Certification
  • One (1) year experience in a Health Plan, PBM, Retail Pharmacy or proven working experience as a data analyst
  • Knowledge of federal and The Commonwealth of Puerto Rico health care delivery and pharmacy regulations/regulatory agencies

What We Offer:

  • Competitive salary and benefits package
  • Ongoing training and professional development opportunities
  • A dynamic and supportive work environment

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