Hybrid Benefits Operations Specialist

Socket.dev; Charlotte (NC); Hybrid; USD 80,000 - 85,000; Full time

Job summary

Judi Health in Charlotte, NC is seeking a Benefit Operations Specialist to lead benefit configuration, claims testing, and QA across client implementations. You will configure new plans, run audits and coordinate with product and client services to ensure accurate, scalable benefits.

The role emphasizes cross-functional collaboration, clear client communication, and the development of testing standards, policies and training for teams. Hybrid work with competitive salary ranges.

Qualifications

• Bachelor’s degree preferred.
• 3+ years of TPA / health plan experience in Medical Benefit configuration, benefit testing, claims monitoring, SPD creation or related areas.
• Experience with Cigna or Aetna preferred.
• Pharmacy, Dental, or Vision experience a plus.
• Self-funded plans, Medicare/Government programs and ERISA experience preferred.
• Tremendous attention to detail, ability to shift priorities easily in a high paced environment.
• Exceptional written and verbal communication skills.
• Experience with Agile and cross-functional product/dev teams is preferred.
• Experience with Excel, SQL and data visualization tools is a plus.

Responsibilities

• Responsible for all aspects of benefit configuration, including new plan setup, plan changes, claims testing, and regular audits.
• Drives cross-functional collaboration with product/dev teams and stakeholders to ensure client requests are configurable.
• Communicate benefit configuration and testing processes to clients in non-technical terms.
• Make recommendations to streamline workflows and systems affecting plan/benefit design for efficiency and quality.
• Develop new benefit options aligning with market needs, including government program expansions.
• Develop standard testing scenarios and review test claims against client benefit design.
• Develop standard policies, procedures and training materials for cross-functional teams.
• Maintain acceptable quality levels and production SLA response times.
• Participate in client meetings to ensure Judi logic aligns with client needs.
• Partner with leadership to design benefit plans meeting regulatory and business parameters.
• Partner with Client Services during go-live to troubleshoot benefit-related discrepancies.
• Support general business or team needs as assigned.

Skills

Attention to detail

Written and verbal communication

Agile familiarity

Cross-functional collaboration

Education

Bachelor’s degree preferred

Tools

SQL

Excel

Data visualization tools

Job description

Judi Health in Charlotte, NC is seeking a Benefit Operations Specialist to lead benefit configuration, claims testing, and QA across client implementations. You will configure new plans, run audits and coordinate with product and client services to ensure accurate, scalable benefits.

The role emphasizes cross-functional collaboration, clear client communication, and the development of testing standards, policies and training for teams. Hybrid work with competitive salary ranges.