Plan Building Specialist - Remote

Overview

The Plan Building Specialist is responsible for the build and maintenance of plan benefits for new and existing groups upon implementation, renewal, and changes.

In Short

• Support Implementation and Account Management teams by consolidating information during new client implementation and/or renewal.
• Translate benefits from ICD10, HCPCS, CPT, CDT, and other insurance billing codes.
• Configure benefits in claims processing systems.
• Generate benefits summaries for internal and external use.
• Ensure compliance with applicable government regulations.
• Audit plans build work of other teammates.
• Process Group terminations as needed.
• Correspond with account managers, account coordinators, and claims department.
• Troubleshoot claims errors and refer escalated issues.
• Support on-boarding and training of new team members.

Requirements

• Experience with insurance billing codes (ICD10, HCPCS, CPT, CDT).
• Knowledge of claims processing systems.
• Strong attention to detail and accuracy.
• Ability to work collaboratively in a team environment.
• Excellent communication skills.
• Experience in auditing and compliance.
• Ability to troubleshoot and resolve issues effectively.
• Experience in training and mentoring new team members.

Benefits

• Dynamic work environment.
• Opportunities for professional growth.
• Inclusive and diverse workplace culture.
• Flexible working arrangements.
• Access to cutting-edge technology.