Plan Building Analyst

About the Role

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

Responsibilities

• 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 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

Requirements

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

Skills

• 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. The internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 100Mbps download/25Mbps upload.

Benefits

• Medical, Dental, Vision, Life, and Disability Insurance
• Generous Paid Time Off
• Tuition Reimbursement
• Employee Assistance Program (EAP)
• Technology Stipend