Benefits Configuration Analyst
About The Position
PDMI is looking to add a Benefits Configuration Analyst to our team! As a Benefits Configuration Analyst, you’ll play a vital role in ensuring client benefit plans are configured accurately and efficiently. The Benefits Configuration Analyst role requires full knowledge of product-specific plan designs and benefit structures across product lines related to their specific product designation in alignment with PDMI’s organizational goals. The Benefits Configuration Analyst is responsible for the daily operations that support the products within their scope. Since 1984, PDMI has provided pharmacy data processing and other flexible, scalable solutions to help our clients meet their business objectives. We offer transparent, pass-through pharmacy processing and other services for private label Pharmacy Benefit Managers (PBMs), vertically integrated health plans and hospital systems. In addition to Pharmacy Benefit Administrative Services, we offer 340B Administration, Hospice and Long-Term Care Services.
Requirements
- Bachelor’s degree preferred or equivalent industry (i.e., healthcare or insurance) experience required.
- Prior experience with benefits and compiling analytical data and reports required.
- Background encompassing electronic claims processing preferred.
- Adaptability and Flexibility
- Analytical Skills
- Attention to Detail
- Benefits Configuration and Administration
- Benefits System Logic and Configuration Documentation
- Continuous Professional Development
- Data Privacy and Security
- Digital and Technological Proficiency
- Document Management
- Emotional Intelligence
- Interpersonal and Professional Communication
- Operational Performance Optimization
- Quality Assurance
- Self-Motivation
- Stakeholder Communication
- Teamwork and Collaboration
- Time and Priority Management
- Workplace Professionalism and Ethical Conduct
Nice To Haves
- Background encompassing electronic claims processing preferred.
Responsibilities
- Analyze, configure, and maintain client benefit plan designs with a high degree of accuracy.
- Interpret business requirements and translate them into system configurations within the claims adjudication platform.
- Support new client implementations and ongoing updates for existing clients, including testing and validation of changes.
- Maintain clear and accurate documentation of system configurations and processes.
- Partner with internal teams to support client needs across claims, eligibility, accumulators, and reporting.
- Participate in projects and recommend process improvements to enhance operational efficiency.
- Perform quality assurance reviews to ensure configuration accuracy and compliance with standards.
- Troubleshoot and resolve issues proactively, minimizing escalation.
- Contribute to team performance by meeting service levels and individual accuracy/timeliness goals.
- Support knowledge sharing, training, and development of team members.
- Ensure compliance with regulatory and industry standards, including HIPAA and NCPDP.
Benefits
- Best Employer: PDMI was voted Best Employer in Ohio for the 5th consecutive year in 2025!
- Meaningful Work: Contribute to improving healthcare quality and efficiency.
- Collaborative Environment: Work with passionate professionals who share your drive.
- Exciting Challenges: Every day brings new opportunities to excel.
- Flexible Work: Fully remote opportunity with a company that cares.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
