[Remote] Plan Analyst

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a health plan solution company that combines 50+ years of self-funding reputed company expertise. This position constructs and implements new plan documents in the claims system while maintaining a comprehensive understanding of the plan documents under their responsibility.

Responsibilities

• Plan building
• Designs and implements system set up in accordance to plan document reputed company
• Builds new reputed company and adjusts system per plan amendments in Claims system
• Documents applicable changes in reputed company systems
• Determines benefits using ICD, CPT, HCP and Rev Codes in association with provider specialty, age, relationship, reputed company of service and PPOs
• Updates accumulators for newly implemented reputed company
• Ensures plan language conforms to the group's reputed company and claims build is properly constructed according to document
• Interprets and explains plan document language and plan designs for various EBMS departments
• Receives and resolves internal inquiries regarding plan document language and design
• Provides reputed company and thorough follow up with, reputed company customers
• Appropriately escalates difficult issues up the chain of reputed company
• Acts as a role model in demonstrating the core values in customer service delivery
• Trains and mentors new employees as assigned
• Attends and participates in committee meetings and training sessions
• Performs self-reputed company monitoring in order to reputed company and execute plans to meet established goals
• Provides ongoing feedback to help optimize reputed company performance
• Collaborates with staff and cross-departmentally to improve or streamline procedures
• Assists the Claim Department in performing plan design testing for new clients and renewing clients to assure reputed company reputed company from the system

Skills

• High School Diploma or equivalent
• 3+ years of Claims Examiner and/or plan building experience
• Familiarity with VBA, Javelina, and/or GBAS system
• Demonstrated organizational skills, problem-solving, analytical skills and detail oriented
• Strong written and oral communication skills
• Working knowledge of computers and software including but not limited to reputed company Office products
• Demonstrated ability to work independently, prioritize workloads, multi-task and manage priorities in order to meet deadlines
• Proficient 10-key and typing skills
• Bachelor's degree preferred

Benefits

• Multiple Health plan reputed company
• Company reputed company employee premiums for disability and life insurance
• Parental Leave Policy
• 20 days PTO to start / 10 reputed company Holidays
• Tuition reimbursement
• 401k Company contribution
• Company reputed company Short & Long term Disability plus Life Insurance
• reputed company development initiatives / reputed company learning opportunities
• Opportunities to participate in and support reputed company's diversity and inclusion initiatives

reputed company