Senior Plan Design Review – Builder, Self-Funded Healthcare Plans
Cobalt Benefits Group, LLC (DBA: Blue Benefit Administrators, CBA Blue & EBPA)
full-time
Posted on:
Location Type: Remote
Location: Minnesota • United States
Visit company websiteExplore more
Salary
💰 $80,000 - $95,000 per year
Job Level
About the role
- Join our team at Cobalt Benefits Group and start an exciting new career in employee benefits solutions.
- Read and interpret benefits to build out the benefit plans by coding, building, revising, and maintaining self-insured healthcare plans in the claims adjudication system.
- Ensure that both the plan documents and the plans within the system are aligned with regulatory standards and client specifications.
- Collaborate with internal implementation teams, account managers, and other stakeholders to ensure the accurate setup of new plans and updates to existing plans.
- Troubleshoot and resolve plan build issues or errors in the claims adjudication system to ensure proper claim processing.
- Conduct ongoing research on evolving healthcare regulations and adjust documents and plan builds accordingly.
- Provide guidance to junior staff and internal teams on the proper application of plan design principles and system builds.
Requirements
- Bachelor’s degree in Business, Healthcare Administration, Legal Studies, or a related field (or equivalent experience).
- A minimum of 5 years of experience in benefit plan documentation, system plan building, or self-insured plan administration.
- Extensive knowledge of healthcare plan documents and self-insured industry practices, including regulatory compliance requirements (ERISA, ACA, HIPAA).
- Strong technical proficiency in claims adjudication systems and plan build processes.
- Experience working with third-party administrators (TPAs), stop-loss carriers, and brokers is highly preferred.
- Exceptional analytical and problem-solving skills with the ability to work independently and handle complex plan design and system build tasks.
- Strong organizational skills and the ability to manage multiple tasks and projects with attention to detail.
- Proficiency in Microsoft Office (Word, Excel, Outlook) and familiarity with document management and claims adjudication systems.
- Excellent communication skills, with the ability to explain complex concepts clearly to internal teams, brokers, and clients.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
benefit plan documentationsystem plan buildingself-insured plan administrationclaims adjudication systemsregulatory complianceplan design principlesanalytical skillsproblem-solving skillsattention to detail
Soft Skills
organizational skillscommunication skillsindependent workcollaborationguidance