Associate Benefit Specialist - National Remote

Lensa; Hartford (CT); Remote; USD 60,000 - 80,000; Full time

Job summary

A leading career site is seeking an Associate Benefit Specialist to join the Benefit Operations Management team. This full-time position involves analyzing benefit requests, implementing pharmacy benefits, and maintaining accurate system configurations. Candidates should have a high school diploma and at least one year of healthcare experience, with strong analytical and organizational skills. Telecommuting options are available.

Benefits

Comprehensive benefits package

Incentives and stock purchase options

401k contributions

Qualifications

• At least 1 year of healthcare experience required.
• Proficiency in Microsoft Word and Excel.
• Must be 18 years or older.

Responsibilities

• Analyze benefit requests and gather data for implementation.
• Implement and maintain benefit requirements in the RxCLAIM system.
• Collaborate with departments for benefits maintenance.

Skills

Analytical skills

Problem-solving skills

Attention to detail

Communication

Organizational skills

Education

High School Diploma / GED

Tools

Microsoft Word

Microsoft Excel

Job description

2 days ago Be among the first 25 applicants

Lensa is the leading career site for job seekers at every stage of their career. Our client, UnitedHealth Group, is seeking professionals. Apply via Lensa today!

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data, and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits, and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

The Benefit Operations Management (BOM) team is responsible for error-free point of sale pharmacy script adjudication. An Associate Benefit Specialist will play a critical role by partnering with clients and Optum Rx stakeholders to assess, define, and perform pharmacy benefit implementations and ongoing maintenance within the RxCLAIM adjudication system. This includes new plan builds, updates to existing plans, copy/change requests, and global updates. It’s a fast-paced, high-volume environment that requires independence while maintaining adherence to company policies and guidelines. Accuracy is vital and subject to internal and external audits to ensure system configuration aligns with client benefit requirements and guarantees.

Assets needed for an Associate Benefit Specialist include personal accountability, attention to detail, analytical and problem-solving skills, excellent conflict resolution skills, strong written and verbal communication, superior organizational skills, innovative thinking, and the ability to manage multiple projects and prioritize effectively.

This is a full-time position, Monday - Friday, with flexibility to work any shift within our normal business hours of 8:00 AM - 5:00 PM local time. Occasional overtime or weekend work may be required.

Training will be paid, with hours from 8:00 AM - 5:00 PM, Monday - Friday.

You’ll have the flexibility to telecommute from anywhere within the U.S. as you take on challenging tasks.

Primary Responsibilities

• Analyze benefit requests and gather data to ensure proper implementation in the RxCLAIM system
• Implement and maintain benefit requirements within the system according to client specifications and timelines
• Use system tools and follow documented processes for job functions
• Collaborate with cross-functional departments to implement and maintain benefits, including client and pharmacy pricing, formulary updates, clinical programs, and specialty drug pricing
• Validate system benefit configurations and perform claim testing for accuracy
• Conduct peer reviews as assigned
• Research and respond to claims processing inquiries promptly
• Adhere to client performance guarantees when applicable
• Participate in meetings and perform additional duties as assigned

We offer a rewarding environment with clear performance expectations and development opportunities.

Required Qualifications

• High School Diploma / GED or equivalent work experience
• Must be 18 years or older
• At least 1 year of healthcare experience
• Proficiency in Microsoft Word and Excel
• Availability to work flexible shifts during business hours, with possible overtime or weekends

Preferred Qualifications

• Certified Pharmacy Technician (CPhT)
• Experience with RxCLAIM or other claim adjudication systems
• Retail pharmacy or PBM experience

Telecommuting Requirements

• Secure handling of sensitive documents
• Dedicated, private work area
• Reliable high-speed internet connection

Soft Skills

• Critical thinking and stakeholder communication skills
• Data analysis and problem-solving abilities
• Effective verbal and written communication
• Independent and team work capabilities
• Growth mindset and multitasking skills
• Proficiency with tools and technology for daily functions
• Experience in benefits implementation and maintenance

The hourly pay range is $23.70 to $46.35, based on experience and location. Benefits include comprehensive packages, incentives, stock purchase options, and 401k contributions. The application deadline is at least 2 business days from posting or until a sufficient candidate pool is reached.

UnitedHealth Group is committed to diversity, equity, and inclusion, and is an equal opportunity employer. Candidates must pass a drug test prior to employment.