Note: The job is a remote job and is open to candidates in USA. Allied Benefit Systems is seeking a Plan Building Analyst to analyze plan documents and accurately build and maintain group setups in the Qiclink System. The role codes and updates medical, dental, and vision plans, maintains benefit-processing programs, audits work, supports automation, tests system upgrades, and resolves benefit-related issues.
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 in order 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
Skills
- Bachelor's degree or equivalent work experience required
- Must have 3 or more years of comprehensive experience with the building and coding of medical, dental and vision plans
- Must have a minimum of 3 years' experience using the Qiclink system
- Must have strong analytical skills and knowledge of computer systems and CPT and ICD-9 coding terminology required
- Proficient in the use of Excel and Word programs
- Experience with or ability to learn Microsoft Access
- Strong written and verbal communication skills required
- This is a standard desk job requiring extended sitting and computer work
- Remote
Benefits
- Medical Insurance
- Dental Insurance
- Vision Insurance
- Life Insurance
- Disability Insurance
- Generous Paid Time Off
- Tuition Reimbursement
- Employee Assistance Program (EAP)
- Technology Stipend
- Remote-friendly culture offering flexibility and the comfort of working from home
Company Overview