Benefit Analyst - Employee Benefits Large Group
Kapnick Insurance · Maumee, OH · 2 days ago
Human ResourcesFull-time
Key Responsibilities
- Participate in client-facing meetings, including renewal reviews, claims reviews, and strategic planning discussions.
- Partner with Client Executives to present and explain claims experience, utilization trends, and financial drivers in a clear and professional manner.
- Serve as an analytical resource for clients and internal teams, responding to questions related to claims performance, plan design, and cost containment strategies.
- Support large employer groups (typically 100+ lives) across a variety of funding arrangements, including fully insured, self-funded, level-funded, reference-based pricing (RBP), and alternative solutions such as direct primary care (DPC).
- Perform detailed claims analysis using internal and external analytics platforms and reporting tools.
- Analyze large and complex claims datasets to identify trends, cost drivers, utilization patterns, and opportunities for improvement.
- Prepare and deliver monthly and ad-hoc claims and utilization reports, including written observations and insights.
- Translate claims data into actionable insights that support renewal strategy, plan design evaluation, and long-term cost management.
- Ensure accuracy and consistency of claims and enrollment data through post-renewal data validation and ongoing maintenance.
- Develop, maintain, and enhance client-facing dashboards and reports using Kapnick-approved analytics platforms.
- Demonstrate strong technical proficiency in navigating, interpreting, and troubleshooting claims analysis tools.
- Utilize benchmarking and comparative tools to provide context and performance insights for clients and service teams.
- Support renewal development by analyzing claims experience, underwriting results, and funding outcomes.
- Develop RFPs based on internal strategy discussions and follow through with carriers on submissions and quotation status.
- Prepare financial and analytical summaries to support carrier negotiations and plan recommendations.
- Collaborate with internal analytics, service, and client teams to ensure alignment and consistent reporting.
- Contribute ideas for process improvements, reporting enhancements, and increased efficiency.
- Assist with department projects and initiatives as assigned.
Requirements
- Bachelor’s degree in Mathematics, Finance, Business, Economics, or a related field preferred.
- 5-7 years of experience in employee group benefits, with experience supporting large group clients.
- Strong understanding of medical claims data, funding arrangements, renewals, and carrier underwriting.
- Demonstrated experience working in claims analysis and reporting tools, with the ability to interpret and explain data to non-technical audiences.
- Advanced computer skills in Microsoft (Excel, Outlook, Word, and PowerPoint).
- Familiarity with carrier underwriting tools (employee benefits) and agency management systems preferred.
- Ability to manage multiple priorities, meet deadlines, and work effectively in a client-facing environment.