Plan Documents & Compliance Specialist (SPD/EOC)

The Health Plan of West Virginia Inc; Wheeling (WV); On-site; USD 32,000 - 42,000; Full time

Job summary

The Health Plan of West Virginia Inc. seeks a Document Coordinator for full-time clerical work in Wheeling, WV. You will develop and maintain Summary Plan Documents (SPD) and Evidence of Coverage for self-funded and fully insured clients, ensuring accuracy and regulatory compliance.

Responsibilities include amendments, SERFF filings, benefit grids, pricing support, and collaboration with compliance and sales teams. Strong attention to detail and organizational skills are essential.

Qualifications

• High School diploma or GED required.
• Associate degree or equivalent work experience preferred.
• Experience with document development and maintenance.
• Proficiency in MS Word and Adobe Acrobat.
• Strong organization, attention to detail, and prioritization.
• Ability to work independently with limited supervision.

Responsibilities

• Develop and maintain Summary Plan Documents (SPD) for self-funded clients.
• Create Amendments and Restatements when revisions are needed.
• Interact with State Insurance Departments on required product form filings through SERFF.
• Develop and maintain Evidence of Coverage for fully insured plans.
• Create and update Summary of Benefits and Coverage per ACA guidelines.
• Maintain Benefit Plan Grids for Fully Insured and MEWA.
• Prepare administrative service agreements for ASO clients.
• Assist with pricing proposals and renewal pricing as needed.
• Keep up with PDM updates and regulatory PHIA webinars.
• Perform quality reviews and edits of documents.
• Provide documents to compliance for audits as needed.
• Support special projects for the Director/SVP.

Skills

Attention to detail

Organizational skills

Verbal communication

Interpersonal skills

Independent work

Adaptability

Education

High School Diploma or GED

Associate Degree or comparable experience

Tools

Microsoft Word

Adobe Acrobat

Job description

The Health Plan of West Virginia Inc. seeks a Document Coordinator for full-time clerical work in Wheeling, WV. You will develop and maintain Summary Plan Documents (SPD) and Evidence of Coverage for self-funded and fully insured clients, ensuring accuracy and regulatory compliance.

Responsibilities include amendments, SERFF filings, benefit grids, pricing support, and collaboration with compliance and sales teams. Strong attention to detail and organizational skills are essential.