Plan Builder

The Key Family of Companies

Indianapolis (IN)

Remote

USD 50,000 - 70,000

Full time

14 days+

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Benefits offered by this job

Comprehensive benefit package

Competitive salary

Job summary

A healthcare benefit administration firm is seeking a Plan Builder for a remote position. The successful candidate will analyze and code medical plans while ensuring accurate processing of claims. This entry-level role requires strong analytical skills and proficiency in VBA, as well as experience in building and coding medical benefits. A comprehensive benefits package is included.

Qualifications

2+ years of experience with building and coding medical, dental and vision plans.
2-3 years' experience on the VBA system.
Professional interaction with team members and departments.

Responsibilities

Review and code plan documents accurately.
Assist in the auto adjudication of claims.
Thoroughly test all coding changes.

Skills

Experience with building and coding medical plans

Strong analytical skills

Knowledge of CPT, HCPCS, and ICD-9 coding

Proficient in Excel and Word

Ability to prioritize and organize work

Tools

VBA system

Job description

Key Benefit Administrators is currently seeking a Plan Builder to join the team. This is a remote position and includes a comprehensive benefit package and competitive salary!

About Key Benefit Administrators

We are on a mission to improve health and stabilize insurance costs for local communities. KBA was founded in 1979 as a privately owned full-service group benefit administration firm specializing in self-funded medical plans and is now one of the country's largest independently owned third party administrators. We pride ourselves on having supportive leadership, a family atmosphere, and a high performing culture - ask our employees - they have agreed that we are a Top Workplace since 2013.

Position Summary

The Plan Builder is responsible for analyzing medical plan documents to accurately build and maintain our clients' plan of benefits using the VBA processing system for the most automated and correct adjudication of claims.

Essential Duties and Responsibilities

Review plan documents, amendments, policies and mandates and coordinate with other departments' staff to ensure difficult, detailed benefit levels within documents can be accurately coded
Provide feedback on difficult benefits that require manual intervention and suggest changes that would auto adjudicate
Accurately code and update coding on plans based on the document/amendment
Assist in auto adjudication of claims by coding benefits that require no manual intervention
Thoroughly test all changes for renewals, new plans, and amendments
Create and maintain group documentation to ensure the correct processing of claims when manual intervention is required
Analyze and take appropriate action to correct problems identified through claim referrals
Perform other work-related duties as assigned by manager

Does this sound like you?

A minimum of 2 or more years of comprehensive experience with the building and coding of medical, dental and vision plans
A minimum of 2-3 years' experience on the VBA system
Strong analytical skills and knowledge of CPT, HCPCS, and ICD-9 coding terminology
General knowledge and familiarity with federal laws affecting self-funding
Proficient in the use of the Excel and Word programs
Accountable and able to multi-task, work well under pressure, prioritize and organize work
Professional and respectful interaction with other team members and departments
Ability to communicate professionally and effectively both orally and electronically

If you are unable to complete an application for the Plan Builder position due to a disability, contact Human Resources by calling 800-560-3539 to ask for an accommodation or an alternative application process.

All qualified applicants for the Plan Builder position will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender.

Seniority Level