The Plan Document Analyst drafts, revises and maintains ERISA-compliant Plan Documents and amendments, Summary Plan Descriptions, and ACA-compliant Summaries of Benefits and Coverages as directed by the Plan Administrator, ensuring these documents are in compliance with all applicable federal laws and regulations. Accuracy of these documents is crucial due to potential excess loss and/or Plan Fiduciary financial impacts. Pursuit and acquisition of signed and approved documents supports satisfaction of the BCBS Association’s MTM Source of Truth requirements.
EDUCATION
Bachelor’s degree in Technical Writing, Business, Healthcare Management or related field. In lieu of degree, five (5) years' non-clerical experience with an insurance, managed care or healthcare organization will be considered.
EXPERIENCE
Minimum three (3) years' writing documentation or instructional materials experience.
Minimum three (3) years' analysis and/or research experience.
In-depth knowledge of managed care, health insurance or third-party administrative services.
Knowledge of products and services associated with self-funded clients preferred.
Knowledge of federal and state laws and regulations impacting self-funded clients preferred.
Project Management experience preferred.
• Collaborative Communications
• Continuous Learning
• Cross-Functional Communications
• Cross-Functional Planning
• Customer Relationship Management (CRM)
• Interpersonal Relationship Management
• Microsoft Excel
• Microsoft Word
• Oral Communications
• Problem Sensitivity
• Process Improvements
• Researching
• Service Oriented
• Writing
• Written Communication
• Analyzes and resolves issues reported by external and internal users.
• Attends and/or facilitates new group implementation meetings to obtain detailed benefit information.
• Collaborates with Legal to resolve compliance issues.
• Coordinates Plan Document language with the Benefit team for purposes of system configuration and benefit administration. Ensures systems configuration leadership is aware of problems and the actions taken to correct problems.
• Develops and maintains Plan Documents, amendments, Summary Plan Descriptions, and Summaries of Benefits and Coverages; ensuring that all documents are signed or approved in a timely manner by the Plan Administrator through direct contact with the Plan Administrator and coordination through the regional offices. Maintains electronic storage of Plan Documents and amendments for internal staff and Web-based storage for the clients.
• Performs other duties as assigned.
• Provides support to the Benefit Team and internal team.
• Utilizes an internet-based Plan Document system to create the initial Plan Document template. Creates and maintains libraries for the purposes of custom-tailoring of each document with language specific to the plan administration, benefit plan design, and client practices.
This position is identified as level three (3). This position must ensure the security and confidentiality of records and information to prevent substantial harm, embarrassment, inconvenience, or unfairness to any individual on whom information is maintained. The integrity of information must be maintained as outlined in the company Administrative Manual.
Segregation of duties will be used to ensure that errors or irregularities are prevented or detected on a timely basis by employees in the normal course of business. This position must adhere to the segregation of duties guidelines in the Administrative Manual.
Regular
ADA Requirements
1.1 General Office Worker, Sedentary, Campus Travel - Someone who normally works in an office setting or remotely and routinely travels for work within walking distance of location of primary work assignment.
