Plan Design System Coder

Into Design Systems; Southwestern Ontario; Hybrid; CAD 44,000 - 73,000; Full time

Job summary

Into Design Systems is seeking a Plan Design System Coder to configure and maintain Group Benefits plan information within administrative and claims systems, translating policy documents into precise system coding in a hybrid Waterloo, Ontario environment.

You will manage multiple plan setups and amendments, review outputs, and ensure accuracy and quality while coordinating with teams to minimize downstream impacts on claims processing.

Qualifications

• Strong knowledge of Group Benefits plan structures.
• Understanding downstream impacts of coding on claims and admin.
• Experience with administrative and claims systems.
• Ability to interpret policy applications, amendments, plan provisions and supporting documentation and translate requirements into accurate system configuration.
• Excellent attention to detail and quality.

Responsibilities

• Configure routine and complex new plans and amendments within applicable Group Benefits administrative and claims systems based on approved plan documentation.
• Translate plan design requirements into the appropriate system coding and configuration.
• Review system-generated reports 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.
• 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.

Skills

Group Benefits

Plan structures

Claims systems

Policy interpretation

Analytical thinking

Attention to detail

Job description

The Plan Design System Coder configures and maintains Group Benefits plan information within administrative and claims systems, translating policy applications and amendments into system coding and validating system changes to identify downstream impacts for claims processing and plan administration. The posting is for Manulife/John Hancock, the role is an existing vacancy, and the working arrangement is hybrid. Referenced salary for Waterloo, Ontario is expected to be between $43,875.00 CAD and $73,125.00 CAD.

What you'll do

• Configure routine and complex new plans and amendments within applicable Group Benefits administrative and claims systems based on approved plan documentation
• 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 
• 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

What they're looking for

• 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
• 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