Description
The Benefit Analyst configures, maintains, and validates member benefits in claims adjudication and benefits administration systems. The role translates benefit plan documents, regulatory requirements, and business rules into system configurations, implements annual and mid-year benefit updates, supports testing and quality assurance, resolves claims adjudication issues, and ensures compliance with CMS and other regulatory requirements. The position requires a high school diploma or GED and 3–5 years of experience in health insurance, managed care, claims configuration, or benefit administration.
