Rx Claims Config & Plan Migration Specialist

Randstad Digital; Natchitoches (LA); On-site; USD 41,000 - 51,000; Full time

Job summary

Randstad Digital in United States (Louisiana) is hiring for a contract position focused on benefit configuration in a claims processing environment. You will map rules between platforms, perform QA, and support onboarding across multiple software systems, ensuring HIPAA compliance and data accuracy.

The role requires 2 years’ PBM/claims processing experience, strong Excel/Outlook/Word/PowerPoint skills, and excellent communication.

Qualifications

• 2 years’ experience in PBM environment using a claims processor for benefit design or configuration.
• Proficient with MS Office suite (Excel, Word, PowerPoint, Outlook).
• Strong written and verbal communication, organization, and time management.
• Ability to collaborate and adapt to new technology quickly.

Responsibilities

• Manage tickets in a ticketing system and resolve adjudication queue issues promptly.
• Adjudicate benefits across multiple platforms per SOP/DTP; onboard clients and terminate programs.
• Support HIPAA compliance and participate in required HIPAA training.
• Coordinate with Implementation, EDI, Clinical, Client Experience teams on plan designs.
• Generate reports to assist client migrations and manage internal permissions.

Skills

PBM experience

Excel

Word

PowerPoint

Outlook

Verbal communication

Written communication

Time management

Problem solving

Collaboration

Adaptability

Attention to detail

Leadership

Education

High School

Tools

MS Excel

Word

PowerPoint

Outlook

Job description

Randstad Digital in United States (Louisiana) is hiring for a contract position focused on benefit configuration in a claims processing environment. You will map rules between platforms, perform QA, and support onboarding across multiple software systems, ensuring HIPAA compliance and data accuracy.

The role requires 2 years’ PBM/claims processing experience, strong Excel/Outlook/Word/PowerPoint skills, and excellent communication.