Welfare Benefit Plan Specialist - 008630

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.

Salary Range:

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 additional to internal equity. The posted salary range reflects just one component of Excellus's 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.

Min: $19.71 an hour - Max: $32.83

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 the Lifetime Healthcare Companies, 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, and Access). By activating our employees' experiences, skills, and perspectives, 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.

OUR COMPANY CULTURE:

Employees are united by our Lifetime Way Values & Behaviors that include compassion, pride, excellence, innovation, and having fun! We aim to be an employer of choice by valuing workforce diversity, innovative thinking, employee development, and by offering competitive compensation and benefits.

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

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)