Jobgether

Compensation

Full Description

This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Benefit Design and System Support Analyst (REMOTE) in the United States. As a Benefit Design and System Support Analyst, you will play a key role in ensuring the accurate configuration, support, and management of benefit systems for clients and internal teams. You will work closely with cross-functional teams, including account management, clinical, implementation, and programming, to troubleshoot issues, validate data, and maintain system integrity. This role offers an opportunity to drive operational excellence, improve benefit processes, and contribute to the overall efficiency and accuracy of claims processing. You will also be responsible for auditing, quality assurance, and providing actionable insights to support business objectives. This remote position allows you to collaborate with a distributed team while influencing the design and delivery of client benefit solutions. \n Accountabilities Provide system support and expertise for benefit plan design and claims processing systems. Manage, troubleshoot, and resolve tickets in the claims processing queue efficiently. Adjudicate and verify information across multiple software platforms. Facilitate benefit designs for new and existing clients based on documentation and requirements. Communicate and coordinate with Implementation, Clinical, and EDI teams regarding system updates and data files. Conduct financial audits and error resolution for benefit designs, presenting findings to Account Management or Leadership teams when needed. Collaborate with external programming teams to identify and correct software issues. Participate in quality assurance initiatives to maintain and improve internal processes. Ensure compliance with HIPAA and handle PHI responsibly. Stay adaptable to evolving responsibilities and take ownership of new tasks as assigned. Requirements Associate or Bachelor’s degree preferred. 2–3 years of experience in a PBM environment, health plan, pharmacy chain, or managed care organization in a systems or plan design role. Intermediate to advanced proficiency in Microsoft Excel, Word, PowerPoint, and Outlook. Strong problem-solving skills with high attention to detail and thoroughness. Excellent verbal and written communication skills; able to collaborate effectively with internal and external teams. Strong organizational skills and ability to manage multiple priorities. Adaptable to new technologies and systems with a continuous learning mindset. Knowledge of benefit design processes and claims adjudication preferred. Benefits Comprehensive medical, dental, and vision insurance. Disability and life insurance coverage. Employee Assistance Program (EAP) for mental and emotional well-being. Generous paid time off (PTO) and flexible work arrangements. Annual performance reviews and professional development plans. Retirement plan with immediate company match and full vesting. Opportunity to work remotely with a supportive and collaborative team. \n Jobgether is a Talent Matching Platform that partners with companies worldwide to efficiently connect top talent with the right opportunities through AI-driven job matching. When you apply, your profile goes through our AI-powered screening process designed to identify top talent efficiently and fairly. 🔍 Our AI evaluates your CV and LinkedIn profile thoroughly, analyzing your skills, experience, and achievements. 📊 It compares your profile to the job’s core requirements and past success factors to determine your match score. 🎯 Based on this analysis, we automatically shortlist the three candidates with the highest match to the role. 🧠 When necessary, our human team may perform an additional manual review to ensure no strong profile is missed. The process is transparent, skills-based, and free of bias — focusing solely on your fit for the role. Once the shortlist is completed, we share it directly with the company that owns the job opening. The final decision and next steps (such as interviews or additional assessments) are then made by their internal hiring team. Thank you for your interest! #LI-CL1