[Hiring] Medical Plan Building Analyst @Allied Benefit Systems

Role Description

The Medical Plan Building Analyst (Plan Building Analyst) analyzes plan documents to accurately build and maintain group set-up in the Qiclink System.

Essential Functions

• Accurately code self-funded and fully insured groups based on the plan document.
• Accurately update coding for all plan changes.
• Set up and maintain HRA processing plans.
• Maintain applicable programs to ensure the appropriate sharing of prescription accumulators.
• Audit the accuracy of all tasks completed.
• Create and maintain group documentation to ensure the correct processing of claims when manual intervention is required.
• Utilize excel spreadsheets and access databases in order to efficiently complete all tasks.
• Assist in automation by coding benefits that require no intervention.
• Manually add accumulators for new groups when necessary.
• Coordinate with plan documentation and account management staff to ensure difficult, detailed benefit levels can be accurately coded.
• Analyze and take appropriate action to correct any problems identified through referrals from claims, plan tester and customer service.
• Test and provide documentation for each system upgrade.
• Learn, adhere to, and apply all applicable privacy and security laws, including but not limited to HIPAA, HITECH and any regulations promulgated thereto.
• Attend continuing education classes as required, including but not limited to HIPAA training.
• Respond timely and accurately to all benefit related questions that come to Plan Building.
• Other duties as assigned.

Qualifications

• Bachelor’s degree or equivalent work experience required.
• Must have 3 or more years of comprehensive experience with the building and coding of medical, dental and vision plans.
• Must have a minimum of 3 years’ experience using the Qiclink system.
• Must have strong analytical skills and knowledge of computer systems and CPT and ICD-9 coding terminology required.
• Proficient in the use of Excel and Word programs.
• Experience with or ability to learn Microsoft Access.
• Strong written and verbal communication skills required.

Requirements

• Accountability.
• Analytical Thinking.
• Collaboration.
• Communication.
• Customer Focus.
• Functional Expertise.
• Initiative.

Physical Demands

This is a standard desk job requiring extended sitting and computer work.

Work Environment

Remote.

Benefits

• Medical, Dental, Vision, Life and Disability Insurance.
• Generous Paid Time Off.
• Tuition Reimbursement.
• EAP.
• Technology Stipend.