[Hiring] Plan Builder @Key Family of Companies

Role Description

Key Benefit Administrators is currently seeking a Plan Builder to join the team. We are excited to speak to qualified candidates about this work from home opportunity. This is a remote position and includes a comprehensive benefit package and competitive salary!

The Plan Builder is responsible for analyzing medical plan documents to accurately build and maintain our clients' plan of benefits using the VBA processing system for the most automated and correct adjudication of claims.

Essential Duties and Responsibilities

• Review plan documents, amendments, policies and mandates and coordinate with other departments' staff to ensure difficult, detailed benefit levels within documents can be accurately coded.
• Provide feedback on difficult benefits that require manual intervention and suggest changes that would auto adjudicate.
• Accurately code/update coding on plans based on the document/amendment.
• Assist in auto adjudication of claims by coding benefits that require no manual intervention.
• Thoroughly test all changes for renewals, new plans, and amendments.
• Create and maintain group documentation to ensure the correct processing of claims when manual intervention is required.
• Analyze and take appropriate action to correct problems identified through claim referrals.
• Perform other work-related duties as assigned by manager.

Qualifications

• A minimum of 2 or more years of comprehensive experience with the building and coding of medical, dental and vision plans required.
• A minimum of 2-3 years' experience on the VBA system required.
• Must have strong analytical skills and knowledge of CPT, HCPCS, and ICD-9 coding terminology.
• Must have general knowledge and be familiar with federal laws affecting self-funding.
• Proficient in the use of the Excel and Word programs.
• Must be accountable and able to multi-task, work well under pressure, prioritize and organize work.
• Must be able to work professionally, and respectfully with other team members and other departments.
• Ability to communicate professionally and effectively both orally and electronically.

Requirements

• If you are unable to complete an application for the Plan Builder position due to a disability, contact Human Resources by calling 800-560-3539 to ask for an accommodation or an alternative application process.
• All qualified applicants for the Plan Builder position will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender.