Benefit Plan Designer

Job Summary

To support key business initiatives, the remote direct hire Benefit Plan Designer will translate healthcare benefit plan requirements into accurate system configurations, ensuring operational effectiveness and claims administration.

Key Responsibilities

• Analyze benefit plan specifications and convert requirements into system configurations for new implementations and ongoing maintenance
• Coordinate updates and changes to existing plan structures, ensuring accuracy and alignment with business needs
• Investigate processing issues, identify configuration gaps, and deliver effective solutions to enhance operational performance

Required Qualifications

• Minimum of 5 years of experience designing, configuring, or maintaining healthcare benefit plans within a claims administration setting
• Strong knowledge of healthcare benefits, claims processing practices, and medical coding principles
• Proven ability to interpret complex documentation and manage multiple priorities in a high-volume environment
• Experience with benefit administration and claims management systems, with exposure to multiple technologies preferred
• Familiarity with VBA or similar automation tools is preferred, along with a demonstrated history of long-term employment stability