Northwind Health Company
Northwind Health Company offers a national health services platform that brings together drug distribution logistics, home delivery pharmacy, analytics, pharmacy benefits, third-party administration, chronic disease programs, and software—creating a Nexus of Care that improves healthcare costs and outcomes.
This is a full-time position. Remote or hybrid work options will be considered.
Job Summary
The Benefit Configuration Specialist is responsible for configuring and maintaining healthcare and employee benefit plans within our VBA system. This position plays a vital role in ensuring accurate claims processing and compliance by translating plan designs into system logic, validating configurations, and collaborating with cross-functional teams. Candidates should be detail-oriented, analytical, and experienced in healthcare benefits or claims administration systems. Responsibilities
Configure and maintain benefit plans in claims and administration platforms to align with plan documents Analyze plan designs and business requirements to develop accurate system configurations Collaborate with internal teams—including benefits administrators, IT staff, and plan designers—to ensure seamless implementation Troubleshoot and resolve issues related to benefit configuration and claims processing Develop and execute testing scenarios to validate benefit accuracy and system functionality Map benefits to coding systems (e.g., ICD-10, ASC, DRG) to ensure compliant claims processing Monitor regulatory updates and apply necessary configuration changes Perform other related duties as assigned Qualifications
High school diploma or GED required; bachelor’s degree preferred Prior experience with benefit configuration or healthcare claims systems (HealthRules, QNXT, or similar) strongly preferred Exceptional attention to detail and accuracy Ability to interpret complex benefit documents and apply logic to system configuration Strong problem-solving and analytical thinking skills Effective written and verbal communication skills Prior healthcare or insurance industry experience preferred Must pass a pre-employment background check and drug screen. Equal Opportunity Statement
Northwind Health Company is an Equal Opportunity Employer. All qualified applicants will be considered regardless of protected status.
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The Benefit Configuration Specialist is responsible for configuring and maintaining healthcare and employee benefit plans within our VBA system. This position plays a vital role in ensuring accurate claims processing and compliance by translating plan designs into system logic, validating configurations, and collaborating with cross-functional teams. Candidates should be detail-oriented, analytical, and experienced in healthcare benefits or claims administration systems. Responsibilities
Configure and maintain benefit plans in claims and administration platforms to align with plan documents Analyze plan designs and business requirements to develop accurate system configurations Collaborate with internal teams—including benefits administrators, IT staff, and plan designers—to ensure seamless implementation Troubleshoot and resolve issues related to benefit configuration and claims processing Develop and execute testing scenarios to validate benefit accuracy and system functionality Map benefits to coding systems (e.g., ICD-10, ASC, DRG) to ensure compliant claims processing Monitor regulatory updates and apply necessary configuration changes Perform other related duties as assigned Qualifications
High school diploma or GED required; bachelor’s degree preferred Prior experience with benefit configuration or healthcare claims systems (HealthRules, QNXT, or similar) strongly preferred Exceptional attention to detail and accuracy Ability to interpret complex benefit documents and apply logic to system configuration Strong problem-solving and analytical thinking skills Effective written and verbal communication skills Prior healthcare or insurance industry experience preferred Must pass a pre-employment background check and drug screen. Equal Opportunity Statement
Northwind Health Company is an Equal Opportunity Employer. All qualified applicants will be considered regardless of protected status.
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