Client Benefits Specialist

Position SummaryAnalyze client benefit requests, determine best operational approach and perform coding. Validate coding accuracy utilizing various tools to ensure no financial impact or client/participant dissatisfaction. Responsible for meeting or exceeding turnaround time and quality standards. Research client benefit requests/issues and recommend alternative solutions to internal partners in meeting client needs. Provide consultation and benefit expertise to internal partners.QualificationsAnalyze client documentation and other source documentation to interpret client intent. Secure appropriate documentation to meet financial standards and government regulations, e.g. SAS70 and Sarbanes Oxley. Manage tracking entries through completion. Responsible for meeting or exceeding turnaround time/client performance guarantees and quality standards. Determine coding plan for system and process relationships in executing the client request to ensure customer satisfaction and prevent financial risk. Perform coding of the clients’ benefit set-up. Self-monitor work output utilizing quality and testing tools to ensure positive claim adjudication outcomes. Validate testing results performed by the quality team for assigned clients to assess meeting intent.Conduct research and provide information to internal partners on client benefit set-up. Provide system expertise on benefit set-up and recommend alternative solutions to internal partners in meeting client intent. Work directly with client and/or participate in client calls when needed.Proactively pursue opportunities to improve efficiencies and recommend process improvements. Handle tasks/projects as assigned by management.EducationHigh School, Some work Experience or Additional Schooling such as CPhT or Medical Billing CertificationExperience0-2 years related work experience required Caremark Benefits:Caremark offers a competitive salary and comprehensive benefits package that includes company-subsidized medical, dental, and prescription coverage, pay-for-performance bonuses, and a matching 401(k) retirement savings program. Other standard benefits include: life insurance, long-term and short-term disability insurance, flexible spending accounts, tuition reimbursement, employee stock purchase program, supplemental medical coverage, back-up care for your loved ones, generous PTO and holiday time and much more! Caremark is an Equal Opportunity/Affirmative Action Employer and does not accept unsolicited resumes from agencies. COMPANY: Caremark LOCATION: Lincoln, RI 02865 STATUS: Full Time, Employee