Welfare Benefit Plan Specialist

Lifetime Workforce Solutions, LLC; City of Rochester (NY); Vor Ort; USD 33.000 - 52.000; Vollzeit

Zusammenfassung

Lifetime Benefit Solutions is seeking a seasoned Benefits Documentation Specialist to draft, review, and edit welfare benefit plan documents, including SPD/SBCs, and assist with regulatory filings and client inquiries. The role emphasizes accuracy, privacy, and collaboration with internal teams.

The position requires knowledge of ERISA, HIPAA, COBRA, and health care reform, with strong communication skills and attention to detail. Some travel may be required.

Qualifikationen

• Five or more years of claims processing experience with coding knowledge and claim adjudication.

Aufgaben

• Drafts, reviews, and edits welfare benefit plan documentation according to defined standards and processes.
• Prepares and reviews welfare benefit plan Form 5500s and assists with filing.
• Provides clients access to the non-discrimination testing website and assists with questions/tests.
• Establishes and maintains client files, billing records, and information.
• Coordinates with internal departments to implement plan design and respond to inquiries about plan documentation.

Kenntnisse

Claims processing

Coding (ICD9/10)

CPT coding

Adjudication

Paralegal experience

Ausbildung

Associate’s degree in paralegal studies or related field

Tools

Microsoft Office

Jobbeschreibung

Job Description: Summary: Under the direction of Assigned Management, this position drafts, reviews, and edits plan documents and summary plan descriptions (PDs/SPDs), summaries of benefits and coverage (SBC), plan amendments, and summaries of material modifications (SMMs). The position provides general benefit plan consulting services to internal clients regarding benefit plan design, compliance, and documentation.

Essential Accountabilities:

• Drafts, reviews, and edits welfare benefit plan documentation according to defined standards and processes.
• Prepares and reviews welfare benefit plan Form 5500s and assists external clients with filing, as requested.
• Provides external clients with access to the non-discrimination testing website and assists with questions and any tests failures.
• Establishes and maintains requisite client files, billing records, and information.
• Works with internal departments to coordinate the implementation of plan design, responds to internal and external client inquiries with respect to plan design and plan documentation, and attends client meetings, as necessary.
• Acts as a resource to internal clients regarding the interpretation of welfare benefit plan documentation.
• Maintains accurate records and files of all written materials and communications regarding plan design and plan documentation.
• Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies’ mission and values, adhering to the Corporate Code of Conduct, and leading to the Lifetime Way values and beliefs.
• Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures.
• Regular and reliable attendance is expected and required.
• Performs other functions as assigned by management.

Minimum Qualifications:

• Five or more years of claims processing experience including knowledge of coding (ICD9/10, CPT) and claim adjudication processes, paralegal, or related experience. Or Associate’s degree in paralegal studies or a related field with two or more years of employee benefits, paralegal document review, or similar experience.
• Strong analytical ability and attention to detail.
• Good organizational skills and ability to multi-task, work independently, prioritize work assignments, and handle confidential information with discretion.
• Knowledge of relevant provisions of ERISA, Internal Revenue Code, HIPAA, COBRA, and Health Care Reform.
• Excellent oral and written communication skills.
• Demonstrated willingness and ability to learn about welfare benefit plan regulatory requirements, including the willingness and ability to keep up to date with such requirements.
• Knowledge of all Microsoft Office applications.

Physical Requirements:

• Ability to work prolonged periods sitting and/or standing at a workstation and working on a computer.
• Ability to hear, understand, and speak clearly while using a phone, with or without a headset.
• Ability to travel across the Health Plan service region for meetings and/or trainings as needed.

In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position.

Equal Opportunity Employer Compensation Range(s): Grade N7: Minimum: $23.75 - Maximum: $37.70 The salary range indicated in this posting represents the minimum and maximum of the salary range for this position. Actual salary will vary depending on factors including, but not limited to, budget available, prior experience, knowledge, skill and education as they relate to the position’s minimum qualifications, in addition to internal equity. The posted salary range reflects just one component of our total rewards package. Other components of the total rewards package may include participation in group health and/or dental insurance, retirement plan, wellness program, paid time away from work, and paid holidays.

Please note: There may be opportunities for remote work on all jobs posted by the LBS Recruitment team. This decision is made on a case-by-case basis.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

One Mission. One Vision. One I.D.E.A. One you. Together we can create a better I.D.E.A for our communities. At Lifetime Benefit Solutions, we’re on a mission to make our communities healthier and we can't do it without you. We know diversity helps fuel our mission and that's why we approach our work from an I.D.E.A Mindset (Inclusion, Diversity, Equity & Access). By activating the experiences, skills, and perspectives of our employees, we take action toward greater health equity. We aspire to reflect the communities we live in and serve, and strongly encourage people of color, LGBTQ+ people, people with disabilities, veterans, and other underrepresented groups to apply.