What are the responsibilities and job description for the Plan Builder position at Employee Benefit Systems, Inc?
Overview
We are seeking a highly analytical and detail-oriented Plan Builder to join our team. This position is responsible for translating insurance plan documentation into accurate, executable plan configurations within our claims processing system.
The Plan Builder plays a critical role in ensuring that partially self-funded plans are built correctly and can be administered accurately. This requires someone who is comfortable working with complex insurance documentation, understanding how benefits and rates are structured, and using strong mathematical reasoning to determine how a plan should be configured.
This is an excellent position for someone who enjoys puzzles, problem-solving, working with numbers, and figuring out how different pieces of a plan fit together.
Key Responsibilities
Build and configure partial self-funded (PSF) and health reimbursement account (HRA) insurance plans within the claims processing system.
● Carefully review insurance setup paperwork, benefit documents, rate sheets, and other plan documentation to determine how plans should be administered.
● Translate plan requirements into system configurations and program the claims processing system to ensure claims are processed according to the plan provisions.
The individual will also build and configure the system to bill for a variety of benefits, some of which include:
Medical, dental, vision, COBRA, flexible spending accounts (FSA), life insurance, short-term disability, long-term disability.
● Interpret rates that may be structured in different ways, including weekly or monthly rates, and possibly age-rated or other variable rate structures.
● Troubleshoot configuration and calculation issues and make corrections when necessary.
● Maintain a high level of accuracy when working with sensitive plan and benefit information.
Qualifications
● Strong algebraic and mathematical aptitude with the ability to work backward from known information to determine unknown variables.
● Exceptional attention to detail and the ability to carefully interpret complex documentation.
● Ability to learn and work within a proprietary claims processing system.
● Ability to work independently while knowing when to ask questions or seek clarification.
● Strong organizational skills and the ability to manage multiple plan builds and deadlines.
Education & Experience
● Associate’s or bachelor’s degree in mathematics, business, insurance, computer science, or a related field is a preferred.
● Experience in insurance, employee benefits, claims administration, or a similar analytical role is preferred.
Pay: $25.00 - $29.00 per hour
Expected hours: 40.0 per week
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Disability insurance
- Health insurance
- Paid time off
- Vision insurance
Work Location: In person
Salary : $25 - $29