Remote Benefit Plan Configurator I

Western Growers Health; Irvine (CA); On-site; USD 47,000 - 61,000; Full time

Job summary

Western Growers Health seeks a Benefit Plan Builder to assist in configuring medical, dental, pharmacy, vision and ancillary benefits in our claims system. You will translate SPDs and amendments into system configurations and conduct testing and audits to ensure accuracy.

Reporting to the Manager, Benefit Distribution & Installation, you will build, test, and resolve issues, maintaining documentation and supporting process improvements across benefits administration.

Qualifications

• BS/BA preferred in Business, Computer Science, HealthCare Administration or related field.
• Minimum two years of experience in health plan coding, benefit configuration, claims auditing, plan testing, or related health plan administration.

Responsibilities

• Build and configure health benefit plans in the claims system.
• Review SPDs, Plan Documents, amendments to translate into system configuration.
• Configure medical, dental, pharmacy, vision and ancillary benefits.
• Validate configurations with plan documents and guidelines.
• Perform testing and peer audits of benefit builds.
• Document configurations and track resolutions.

Skills

Benefit configuration

Plan testing

Auditing

Analytical skills

Documentation

Education

BS/BA in Business or related field

Tools

Microsoft Office

Job description

Western Growers Health seeks a Benefit Plan Builder to assist in configuring medical, dental, pharmacy, vision and ancillary benefits in our claims system. You will translate SPDs and amendments into system configurations and conduct testing and audits to ensure accuracy.

Reporting to the Manager, Benefit Distribution & Installation, you will build, test, and resolve issues, maintaining documentation and supporting process improvements across benefits administration.