Plan Builder - Vendor Coordinator

About the role

This full-time position runs Monday through Friday, 8 am to 5 pm, with overtime available and an optional remote work arrangement.

Responsibilities

• Create and refine plan structures in the WLT adjudication system
• Set up new groups
• Establish vendor connections
• Update existing plans
• Maintain system tables
• Load fee schedules
• Calculate DRG pricing
• Resolve claim issues
• Work closely with internal teams to interpret client needs and ensure each plan operates accurately and in compliance

Requirements

• Prior experience with plan building and a health plan claims system (required for remote work)
• Ability to troubleshoot claim processing issues
• Experience in auditing plan designs and reporting system errors
• Strong writing skills with proper grammar and structure
• Knowledge of ACA and ability to stay current on regulatory updates
• Ability to collaborate with multiple internal departments

Qualifications

• Experience with plan building and claims adjudication systems
• Proficiency in Microsoft Office
• Familiarity with ACA
• Strong math, organizational, and attention to detail skills

Skills

• Plan building and claims adjudication systems
• Microsoft Office
• ACA knowledge
• Math, organizational, and attention to detail skills

Benefits

• Health, dental, and vision insurance
• 401(k) with company match
• Education assistance
• Employee assistance program
• PTO
• Growth opportunities
• HSA/FSA
• Life insurance
• Short- and long-term disability coverage
• Wellness programs
• Sponsored health clinic
• Company parties

Pay

Earn a competitive hourly wage.

Schedule

Monday through Friday, 8 am to 5 pm, with overtime available and an optional remote work arrangement.