• Job Description

  Req#: 2660341
  Job Type
  
  Full-time
  
  Description
  
  Job Summary:
  
  The Benefits Plan Specialist will assist the Document Team to create, maintain, update and modify the new business and renewal business plan document needs. This position helps create new plan documents, plan amendments and summaries.
  
  Duties and Responsibilities:
  
  • Working with Plan Document Writer, research and amend medical plan documents: Summary of Benefits & Coverage (SBC), Summary Plan Description (SPD); Benefit Plan Descriptions (BPD); Summary of Material Modifications (SMM) or Summary of Material Reduction (SMR).
  • Assist with incorporations of new document wording to support legislative or administrative changes.
  • Manage inventory of documents and status of each from initial need through publication and future edits monitoring and meeting deadlines.
  • Working from templates or existing documents, adjust benefit design and information construction.
  • Submit completed documents or projects within Service Level Agreement timeframes.
  • Work closely with Internal customers to ensure correct documentation is in place.
  • Research Plan Document questions using internal and external sources to validate inquiry responses and documentation issues.
  • Maintain accurate data in various platforms for variety of end users.
  • Writes procedure documentation, in accordance with business goals and legal requirements.
  • Provide timely documentation to users to help them reference, understand how plan changes impact the system.
  • Publish, proofread, and edit documents to ensure ongoing compliance and quality.
  • Maintain accurate data in various platforms.
  
  
  Requirements
  
  Required Knowledge, Skills and Abilities
  
  • Bachelor's degree or equivalent work experience drafting plan documents in a healthcare or benefits TPA setting.
  • 2+ years of experience claims handling, quality control or plan document experience in a healthcare setting. TPA business and process knowledge preferred.
  • Familiarity with, and an understanding of the differences in, each type of Plan Document: SBC, SPD Summary, BPD, SMM, and SMR.
  • Knowledge of medical procedure terminology preferred.
  • Solid working knowledge of standard computer applications including MS Word, Excel, Outlook and PowerPoint.
  • Ability using a computer which includes expert keyboard and navigation skills and learning new programs.
  • Communicate clearly and professionally with internal and external customers.
  • Work effectively as part of a team to achieve established outcomes. Understand other's roles and empower one another to take responsibility to be successful.
  • Demonstrate a collaborative interaction with peers to reach a common goal as well as be a resource to team members and internal/external customers.
  • High attention to detail, excellent analytical and writing skills.
  • Make decisions using available resources and sound judgment.
  • Maintain confidentiality and discretion.
  • Identify and resolve problems in a timely manner.
  • Share knowledge with associates by effectively communicating and providing follow-up. Open to other's ideas and exhibits a willingness to try new things.
  • Demonstrate accuracy and thoroughness; monitor work to ensure quality.
  • Prioritize and plan work activities to use time efficiently.
  • Adapt to changes in the work environment, manage competing demands; able to deal with frequent change, delays, or unexpected events.
  • Follow instructions, respond to direction, and solicit feedback to improve.
  • Act in such a way to instill trust from management, other associates, as well as customers.
  
  Physical Demands - The physical demands described here are representative of those necessary for an employee to successfully perform the essential functions of this job. Reasonable accommodation can be made to enable individuals with disabilities to perform the essential functions.
  
  • Constant: Talk, hear, speak, and use hands and fingers to operate a computer, telephone, keyboard/mouse.
  • Constant: Specific vision abilities required by this job include close vision requirements due to computer work for full shift.
  • Occasional: Lift and/or move up to 10 pounds.
  • Constant: Regular, predictable attendance required.
  • Constant: While performing the duties of this job, the employee is regularly sitting for the full shift.
  
  
  Work Environment - The work environment described is representative of what must be met by an employee successfully perform the essential functions of this job.
  
  • The physical environment is indoors in a controlled climate, office setting. The noise level may be low to moderate.
  
  
  The duties described are representative, but not restrictive of tasks that may be assigned or of the abilities required to do the job. The description is subject to change at any time. Other related duties may be assigned. This description does not alter the at-will status of employment.
  
  Salary Description
  
  25-32/hour

• About the company

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