Plan Design System Coder

Manulife John Hancock; Southwestern Ontario; Hybrid; CAD 90,000 - 120,000; Full time

Job summary

Manulife is seeking a Plan Design System Coder to configure and maintain Group Benefits plan information in administrative and claims systems. You’ll translate plan design requirements from policy applications into precise system coding and ensure accurate reflection of plans.

You will validate changes and assess downstream impacts to support accurate claims processing and ongoing plan administration.

Qualifications

• Strong knowledge of Group Benefits plan structures and client options.
• Understanding downstream impacts of coding decisions on claims processing and plan administration.

Responsibilities

• Configure routine and complex new plans and amendments in Group Benefits systems based on approved plan documentation.
• Translate plan design requirements into accurate system coding and configuration.
• Review system outputs to confirm changes are implemented correctly.
• Interpret policy applications and amendment requirements for correct system configuration.

Skills

Group Benefits knowledge

Plan design translation

Systems configuration

Analytical skills

Attention to detail

Job description

The primary role of the Plan Design System Coder is to accurately configure and maintain Group Benefits plan information within applicable administrative and claims systems. The role translates plan design requirements from policy applications and amendments into system coding, ensuring plan structures, benefits, provisions and related information are accurately reflected within the administrative systems.

The role is also responsible for validating system changes and identifying potential downstream impacts to support accurate claims processing and ongoing plan administration.

Position 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 elevate 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.

Required Qualifications:

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

Preferred Qualifications:

• Strong understanding of applicable administrative and claims systems.
• Ability to interpret policy applications, amendments, plan provisions and supporting documentation and translate requirements into accurate system configuration.
• Ability to identify inconsistencies or missing information and determine when clarification is required before coding.
• Strong analytical, problem-solving and decision-making skills.
• Excellent attention to detail with a strong focus on accuracy and quality.
• Ability to manage multiple priorities and meet established service standards.
• Strong written and verbal communication skills.
• Ability to work collaboratively with Plan Design, implementation partners and other operational areas.
• Ability to adapt to system, process and product changes.

When you join our team:

We'll empower you to learn and grow the career you want.

We'll recognize and support you in a flexible environment where well-being and inclusion are more than just words.

As part of our global team, we'll support you in shaping the future you want to see.

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The role being advertised is an existing vacancy.

About Manulife and John Hancock

Manulife Financial Corporation is a leading international financial services provider, helping people make their decisions easier and lives better. To learn more about us, visit https://www.manulife.com/en/about/our-story.html .

Manulife is an Equal Opportunity Employer

At Manulife/John Hancock, we embrace our diversity. We strive to attract, develop and retain a workforce that is as diverse as the customers we serve and to foster an inclusive work environment that embraces the strength of cultures and individuals. We are committed to fair recruitment, retention, advancement and compensation, and we administer all of our practices and programs without discrimination on the basis of race, ancestry, place of origin, colour, ethnic origin, citizenship, religion or religious beliefs, creed, sex (including pregnancy and pregnancy-related conditions), sexual orientation, genetic characteristics, veteran status, gender identity, gender expression, age, marital status, family status, disability, or any other ground protected by applicable law.

It is our priority to remove barriers to provide equal access to employment. A Human Resources representative will work with applicants who request a reasonable accommodation during the application process. All information shared during the accommodation request process will be stored and used in a manner that is consistent with applicable laws and Manulife/John Hancock policies. To request a reasonable accommodation in the application process, contact [e-mail] .

Referenced Salary Location

Waterloo, Ontario W