Employee Benefits Administrator and Compliance Expert

4 days ago


Westborough, Massachusetts, United States Health Plans Inc Full time

Job Summary

We are seeking a skilled Employee Benefits Administrator and Compliance Expert to join our team at Health Plans Inc. As a Self-Funded Health Plan Benefit Summary Specialist, you will play a crucial role in facilitating client onboarding and managing SBCs (Summary of Benefits and Coverage). Your expertise in writing, organizational, and administrative skills will be essential in preparing SBCs accurately and efficiently.

About the Role

In this position, you will work closely with Implementation and Client Services staff to ensure accurate and timely delivery of documents. You will also maintain ACA-related calculators and corresponding spreadsheets, including the SBC Calculator and the MV Calculator. Your attention to detail and ability to prioritize tasks efficiently will be critical in meeting deadlines.

Responsibilities

  • SBC Preparation: Prepare SBCs for new clients upon implementation and update renewal SBCs for existing clients.
  • Regulatory Compliance: Ensure SBCs comply with regulatory instructions, including when they need to be originally distributed or updated based on various plan changes.
  • Documentation Maintenance: Maintain SBC Manual and applicable templates, incorporating updated language and provisions.
  • Log Management: Update and maintain logs for tracking and distribution of SBCs.
  • Collaboration: Collaborate with Health Plans' Client Services Department and Benefit Compliance Department staff to resolve plan contract-related issues.

Requirements

To succeed in this role, you should have:

  • A Bachelor's Degree or equivalent work experience.
  • Five or more years' related experience, preferably in the healthcare industry.
  • Proficient in Microsoft Office, including Word, Excel, Outlook, and PowerPoint, Teams, SharePoint, OneDrive, and CRM platforms.

Preferred Qualifications

  • Experience with Health and Welfare Benefit Plan SBC drafting.
  • Ability to understand and interpret plan documents and health plan benefit designs.
  • Strong written and oral communication skills.

Salary Information

The estimated salary for this position is $65,000 - $85,000 per year, depending on experience and qualifications.



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