Benefits Plan Design Systems Specialist

Manulife/John Hancock; Southwestern Ontario; Hybrid; CAD 44,000 - 73,000; Full time

Job summary

Manulife/John Hancock in Waterloo, Ontario seeks a Plan Design System Coder to configure and maintain Group Benefits plan information across administrative and claims systems. You will translate plan design requirements into precise system coding, validate changes, and assess downstream impacts to support accurate claims processing and ongoing plan administration.

The role requires strong knowledge of Group Benefits plan structures and the ability to interpret policy applications and amendments,

Qualifications

• Strong knowledge of Group Benefits plan structures and Client Group Options.
• Understanding of downstream impacts of system coding decisions, including impacts to claims processing and plan administration.

Responsibilities

• Configure routine and complex new plans and amendments within applicable Group Benefits administrative and claims systems based on approved plan documentation.
• Accurately translate plan design requirements into the appropriate system coding and configuration.
• Review system-generated reports and outputs to confirm changes have been implemented accurately.
• Interpret policy applications and amendment requirements to determine the appropriate system configuration and identify potential claims or downstream impacts.
• Determine whether plan requirements can be accommodated within existing system functionality and escalate exceptions or concerns when required.
• Create or maintain special system notes when plan requirements cannot be adequately represented through standard system fields.
• Manage multiple new plan setups, amendments, inquiries and rush requests while meeting established service and quality targets.
• Respond to questions regarding system configuration, plan coding and ongoing administration.
• Request and/or create custom dental and health packages and benefit codes when required.
• Identify opportunities to improve coding accuracy, efficiency and processes through continuous improvement practices.
• Maintain a high level of accuracy and attention to detail, recognizing that system configuration directly impacts plan administration, member experience and claims processing.

Skills

Group Benefits

Plan structures

System impacts

Coding accuracy

Job description

Manulife/John Hancock in Waterloo, Ontario seeks a Plan Design System Coder to configure and maintain Group Benefits plan information across administrative and claims systems. You will translate plan design requirements into precise system coding, validate changes, and assess downstream impacts to support accurate claims processing and ongoing plan administration.

The role requires strong knowledge of Group Benefits plan structures and the ability to interpret policy applications and amendments,