Overview
On Site
$60000
Full Time
Job Details
Key Responsibilities:
- Develop, review, and maintain Summary Plan Descriptions (SPDs), Summaries of Benefits and Coverage (SBCs), and related documents for self-insured medical, dental, and specialty benefit plans.
- Interpret and apply federal regulations (ERISA, ACA, COBRA, HIPAA) to ensure plan documents meet legal and compliance standards.
- Lead plan amendments and documentation updates, collaborating with account managers, implementation teams, brokers, and client representatives.
- Analyze and advise on plan design changes, ensuring alignment with regulatory requirements and industry standards.
- Maintain and enhance the electronic library of plan documents, ensuring version control and compliance with company policies.
- Serve as a subject matter expert on self-insured regulations, providing guidance and recommendations to internal stakeholders.
- Conduct research and stay current with evolving legislation to proactively update documents and advise on compliance matters.
- Provide strategic input on process improvements and document standardization to enhance operational efficiency.
- Bachelor’s degree in Business, Healthcare Administration, Legal Studies, or a related field (or equivalent experience).
- Minimum of 3 years of experience in benefit plan document drafting, compliance, or plan administration.
- Extensive knowledge of healthcare plan documents and self-insured industry practices required.
- Strong ability to interpret and apply federal laws and regulations (ERISA, ACA, COBRA, HIPAA).
- Experience working with third-party administrators (TPAs), stop-loss carriers, and brokers is highly preferred.
- Advanced proficiency in Microsoft Office (Word, Excel, Outlook) and document management systems.
- Exceptional analytical skills, attention to detail, and independent problem-solving abilities.
- Strong written and verbal communication skills, with the ability to explain complex concepts clearly.
Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.