The Plan Document Writer will support the Marketing Team with new business needs which include, but are not limited to creating medical plan documents, changes, and creating summaries of benefits and coverage (SBC’s). The schedule varies based on business needs but can be performed between the hours of 6:30 am EST to 3:00 pm EST Monday - Friday.

Primary Responsibilities:

• Evaluates and provides feedback on plan and benefit design. Participates and engages in discussion with internal and external partners related to benefit interpretation
• Research plan provisions contained in benefit plan documents including clarifying ambiguities contained in the plan language and provisions
• Provides timely documentation to users to help them reference, understand plan changes
• Maintains design specifications through documentation and revisions.
• Creating renewal business plan amendments.
• Consult with internal compliance expert and review client plan contracts, SPD’s, SMM’s to ensure compliance with Federal and State law.
• Evaluates impact of client requested exceptions and develops reasonable alternatives to satisfy client’s needs while minimizing the impact on system and operations

Qualifications:

• Undergraduate degree preferred or equivalent combination of education and experience
• Insurance industry and benefit experience preferred
• Knowledge and experience in medical, dental, disability and vision benefits preferred
• Knowledge of major medical benefit application preferred
• Knowledge and experience in medical terminology preferred
• General understanding of compliance and regulatory issues (ERISA, HIPAA, ACA, COBRA)
• Ability to communicate both verbally and in writing
• Computer proficiency in Outlook, Excel Spreadsheets, Power Point, Word Documents, and ability to learn internal systems
• Able to work in fast paced environment
• High attention to detail, excellent analytical, writing and presentation skills
• Identifies priorities and organizes time efficiently to ensure that tasks are completed to meet or exceed deadlines
• Ability to attend company, department, and team meetings as required, including industry training sessions
• Ability to travel at least 10%
• Ability to work outside of normal business hours as needed
• Relevant TPA or payer experience