Benefit Plan Designer

Job Summary

A company is looking for a Benefit Plan Designer to support the creation and maintenance of healthcare benefit plans within a claims environment.

Key Responsibilities of the Benefit Plan Designer:

• Design, build, and implement new healthcare benefit plans within claims processing systems
• Interpret complex plan documents and convert benefit requirements into system configurations
• Investigate and resolve plan-related system issues, ensuring compliance with benefit design intent

Qualifications and Skills for the Benefit Plan Designer:

• Proven experience working with healthcare benefit plans and claims processing
• Hands-on experience configuring or building plans within a claims administration system
• Working knowledge of ICD coding and its impact on claims and benefit determination
• Familiarity with tools or systems such as VBA, Javelina, GBAS, or comparable platforms
• Strong analytical skills to translate written documentation into technical system solutions