[Remote] Plan Building Analyst

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 build and maintain group setups in the Qiclink System. The role focuses on coding and updating medical, dental, and vision benefits, maintaining processing plans and documentation, auditing work, supporting automation, testing system upgrades, and resolving 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

• Fully remote work arrangement
• Flexibility and the comfort of working from home
• Medical insurance
• Dental insurance
• Vision insurance
• Life insurance
• Disability insurance
• Generous paid time off
• Tuition reimbursement
• Employee Assistance Program (EAP)
• Technology stipend

Company Overview