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Document Compliance Specialist
2 months ago
About Us
Assured Benefits Administrators, Inc. (ABA) is a full-service third-party administrator, or TPA, providing flexible and fully integrated healthcare administration and management solutions across the United States since 1985. We are part of an international healthcare group with more than 35 years of industry experience, and we’re fully integrated with our long-term partners, who are recognized as industry leaders.
Position Summary
To be successful in this role, candidate must be detail oriented, execute tasks with a high degree of accuracy, be well organized, flexible, function autonomously and as part of a team and have strong written and verbal communication skills. The Document Compliance Specialist completes analysis on Summary Plan Descriptions and Summary of Benefits and Coverage. Document Compliance Specialist will assist with the analysis and coordination of implementation for new regulations and legislative requirements in relation to Summary Plan Descriptions and Summary of Benefits and Coverage. A successful candidate will provide timely creation of Plan Documents, Plan Amendments, and Summary of Benefits and Coverage for internal use and submission to internal partners for distribution to clients, brokers/consultants and stop loss carriers as it relates to the client's group health plan(s).
Essential Duties And Responsibilities
The essential functions include, but are not limited to the following:
Analyze and interpret previous carrier's documents to generate a customized plan document for distribution to Internal Operational Team members for release to the Client, Stop Loss Carrier, Associated Cost Containment Vendors and Utilization Management Team.
Identify, research, develop and amend documents to support and comply with legislative requirements, client requests, and/or industry practices.
Assist in education and informational communications to internal and external clients about existing and new plan compliance requirements (annual plan notices, SBCs, etc.) due to existing and new legislative regulations.
Work with supporting departments to resolve issues or provide required information when benefit interpretation varies.
Review, develop, and update Summary of Benefits and Coverage to comply with legislative requirements, plan changes, and client requests.
Perform other projects or tasks as required.
Minimum Qualifications (knowledge, Skills, And Abilities)
Five years of experience in employee benefits, document drafting, or equivalent is preferred.
Comprehensive knowledge of both group health insurance and employee benefits.
Ability to read, analyze and interpret general business periodicals, professional journals, technical procedures, or government regulations.
Ability to organize material according to set standards regarding order, clarity, conciseness, style, and terminology.
Effective business correspondence skills, including issuing prompt and detailed accurate follow-up.
Excellent interpersonal and communication skills (written and verbal).
Commitment to a team-oriented office environment.
Proficient with Microsoft Word, Outlook, Excel, Adobe Pro.
Strong client focus, and service-oriented.
Strong planning and organizational skills.
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