Aptita
Website:
aptita.com
Job details:
📍 Location: Bengaluru / Hyderabad
🕒 Shift: Night Shift
💼 Role: Benefit Configuration SPE/SME
🔹 Key Responsibilities:
✔ Configure and maintain healthcare insurance plan benefits
✔ Setup benefit rules, co-payments, deductibles, coinsurance, authorization requirements, and covered services
✔ Translate benefit plan documents and payer requirements into system configuration logic
✔ Support new plan implementations and product launches across Medicare, Medicaid, and Commercial lines of business
✔ Perform end-to-end testing of benefit configurations to validate plan setup accuracy
✔ Analyze and troubleshoot benefit-related claim errors and resolve configuration issues
✔ Maintain documentation for configuration rules, testing outcomes, and audit compliance
🔹 Preferred Experience:
✔ US Healthcare Payer Operations
✔ Benefit Configuration
✔ Claims Adjudication Support
✔ Medicare / Medicaid / Commercial Plans
✔ End-to-End Testing
✔ Root Cause Analysis
✔ Configuration & Compliance Documentation
Click on Apply to know more.