Benefit Plan Building Specialist - Top Stack

Company is seeking a Benefit Plan Building Specialist who would be responsible for constructing and implementing new benefits plans in the benefits administration system.
 
COMPANY HIGHLIGHTS/RESPONSIBILITIES:

• Design and implement system configuration in accordance to benefit plan description.
• Build new groups and adjust systems per plan amendments in benefits system.
• Research plan provisions contained in benefit plan documents; clarify ambiguities contained in the plan language and provisions.  Ensure plan language conforms to the group’s intent.
• Convert plan provisions to claim system adjudication functions.
• Construct/build benefit plans and related tables within the system.
• Coordinate the development of solutions for system related issues that may prevent the use of automated or standard processing methods.

 
QUALIFICATIONS:

• Associate or bachelor’s degree preferred.
• 3+ years benefit plan build experience; alternately demonstrated progressive experience in a claims processor role of at least 5 years.

• Knowledge of benefit application and plan building for health plans.
• Knowledge and experience in medical terminology including Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), International Classification of Diseases (ICD) 9/ 10 required.