Strategic Benefit Plan Analyst

Reflect Health; Cincinnati (OH); On-site; USD 32,000 - 40,000; Full time

Job summary

Reflect Health in Mason, OH, seeks a Plan Benefit Analyst to analyze health and welfare plans, review SPDs and benefit documents, and ensure accurate reflection in claims systems. This role focuses on benefit design, configuration, and client support.

You will collaborate with Claims, Plan Build, Compliance, and Product teams, research complex benefit questions, validate configurations, and participate in testing and implementation of new plans.

Qualifications

• Experience reading and interpreting benefit plan documents, SPDs, and related materials.
• Ability to analyze medical, dental, vision, and other plan designs and requirements.
• Strong research skills to resolve benefit questions and discrepancies.
• Experience with claims/benefits systems and administration processes is preferred.
• Attention to HIPAA and confidentiality in handling plan data.
• Excellent communication skills for internal teams and clients.

Responsibilities

• Benefit Plan Analysis: Review designs and requirements to understand administration.
• Plan Document Interpretation: Read SPDs and benefit summaries to interpret provisions.
• Benefit Research: Investigate eligibility, coverage, deductibles, coinsurance, and accumulators.
• Claims Support: Research issues to ensure alignment with plan provisions.
• System Validation: Work with Plan Build to ensure configurations reflect documents.
• Benefit Configuration Support: Translate requirements into system specifications.

Skills

Benefits Experience

Plan Interpretation

Analytical Skills

Benefit Knowledge

Claims Knowledge

Systems Experience

Attention to Detail

Communication

Organization

Technology

Adaptability

Confidentiality

Collaboration

Tools

Excel

Word

Data reporting tools

Job description

Reflect Health in Mason, OH, seeks a Plan Benefit Analyst to analyze health and welfare plans, review SPDs and benefit documents, and ensure accurate reflection in claims systems. This role focuses on benefit design, configuration, and client support.

You will collaborate with Claims, Plan Build, Compliance, and Product teams, research complex benefit questions, validate configurations, and participate in testing and implementation of new plans.