Plan Documents Specialist: SPD & Compliance

The Health Plan Of West Virginia Inc; Wheeling (WV); On-site; USD 38,000 - 54,000; Full time

Job summary

The Health Plan Of West Virginia Inc. is seeking a Document Coordinator in Wheeling, WV to develop and maintain Summary Plan Documents (SPD) and Evidence of Coverage for self-funded and fully insured clients. The role requires precise document handling and strong organizational skills.

Responsibilities include amendments, state filings, ACA SBC maintenance, and collaboration with compliance for audits. A high school diploma is required, with preferred associate degree or related experience in

Qualifications

• High School Diploma or GED required.
• Associate Degree or comparable work experience with document development and maintenance preferred.
• Strong experience in Word and Acrobat.
• Willingness to learn additional programs as needed.
• Excellent organization and prioritization skills.
• High attention to detail.
• Ability to work in a high paced environment.
• Adapts easily to changes in processes.
• Strong verbal and interpersonal skills.
• Ability to work independently with limited supervision.
• Knowledge of ERISA and regulatory requirements helpful.
• Paralegal experience appreciated but not required.
• Ability to work in various team oriented situations.

Responsibilities

• SPD development and maintenance for self-funded line of business.
• Amendments and Restatements for SPDs.
• Interact with State Insurance Departments on product form filings via SERFF.
• Evidence of Coverage development and maintenance for fully insured line.
• SBC creation and maintenance per ACA guidelines for Fully Insured and MEWA.
• Benefit Plan Grid creation and maintenance for Fully Insured and MEWA.
• Create and execute all Administrative Service Agreements for ASO Clients.
• Prepare the quarterly RX Rebate listing.
• Keep up with PDM updates as needed.
• Regulatory updates with PHIA webinars.
• Quality reviews and editing of documents.
• Provide documents to compliance for audits as needed.
• Assist in creating sale pricing proposals and renewal pricing proposals.
• Maintain the quoting log and contracts for ASO clients.
• Assist in creating and maintaining Policy and Procedures for the department.
• Assist with external reporting process.
• Support the Director of Implementation and SVP in special projects.

Skills

Organization

Prioritization

Attention to detail

Adaptability

Communication

Independence

Teamwork

Paralegal experience

Willingness to learn

Regulatory knowledge

Education

High School Diploma or GED

Associate Degree or equivalent work experience

Tools

Microsoft Word

Adobe Acrobat

Job description

The Health Plan Of West Virginia Inc. is seeking a Document Coordinator in Wheeling, WV to develop and maintain Summary Plan Documents (SPD) and Evidence of Coverage for self-funded and fully insured clients. The role requires precise document handling and strong organizational skills.

Responsibilities include amendments, state filings, ACA SBC maintenance, and collaboration with compliance for audits. A high school diploma is required, with preferred associate degree or related experience in