Job Description
Imagine360 is seeking a Plan Document Specialist to join the team! This position is responsible for preparing plan documents and summary plan descriptions, and subsequent amendments for clients as requested or necessitated by law. This position maintains a comprehensive understanding of the plan document(s) under their scope of responsibility.
Position Location: 100% remote
Responsibilities include but are not limited to:
- Current Client Plan Documents
- Drafts, restates, and amends Plan Documents (including summary plan descriptions, summaries of benefits and coverage, statement of material modification, and any other benefit summary), for the following plans including without limitation medical, prescription, dental and vision, disability, and executive plans, and all manner of consumer driven health plans under Section 125, Section 132, and health reimbursement arrangements for existing clients.
- Ensures Plan Documents are compliant with applicable state and federal laws and regulations, including but not limited to, ERISA, COBRA, PHSA, HIPAA, and applicable State insurance law.
- Communicates extensively with clients/brokers verbally and in writing to expedite the amendment or restatement of Plan Documents and the printing thereof.
- Coordinates with other EBMS departments and/or team members to expedite the implementation of new benefit structures for new and existing clients to meet established deadlines.
- Identifies areas of inconsistency in the Plan Documents with federal and state laws and works with other EBMS team members as necessary to resolve and clarify the inconsistency in the Plan Documents.
- Distributes and obtains appropriate signatures for new and amended Plan Documents to clients, brokers, EBMS team members, and Stop Loss Carriers.
- Maintains electronic Plan Document Directory to ensure proper documents are available for internal use.
- Distributes current Plan Documents to appropriate EBMS departments.
- New Client Plan Documents
- Acts as a facilitator for the process to create Plan Documents by acting as a liaison between new client, brokers, and assigned EBMS team members to create new Plan Documents to meets client and broker's expectations.
- Drafts Plan Documents (including summary plan descriptions, summaries of benefits and coverage, statement of material modification, and any other benefit summary), for the following plans including without limitation medical, prescription, dental and vision, disability, and executive plans, and all manner of consumer driven health plans under Section 125, Section 132, and health reimbursement arrangements for new client.
- Communicates extensively with client and broker verbally and in writing to expedite the draft Plan Document and the printing thereof...
- Remains current on applicable state and federal laws or regulations that affect all manner of benefit plans and applies knowledge of these laws to identify areas of risk and noncompliance within new client plans.
- Identifies areas of inconsistency in the new client plans with federal and state laws and works with other EBMS team members as necessary to identify a solution for any inconsistency.
- Remains current on Relius Document System.
- Coordinates with other EBMS departments and/or team members to expedite the implementation of new benefit structures for new clients to meet established deadlines.
- Customer Service and Relationship Management
- Organizes and hosts conference calls to determine and prioritize deadlines while escalating issues to the appropriate EBMS team members, clients and brokers.
- Acts as a role model in demonstrating the core values in customer service delivery.
- Provides timely and thorough follow up with, internal and external customers.
- Appropriately escalates difficult issues up the chain of command.
- Serves on committees, work groups, and/or process improvement teams, as assigned, to assist in improving quality/customer satisfaction.
- Recognizes and alerts appropriate supervisor of trends within their scope of responsibility that fall outside of quality parameters.
- Performs self-quality monitoring in order to develop and execute plans to meet established goals.
- Provides ongoing feedback to help optimize quality performance.
- Collaborates with others and cross-departmentally to improve or streamline
- Develops new or improves current internal processes to improve quality
- Maintains current on all state and federal laws or regulations affecting benefit
- Trains and mentors new employees as assigned.
Required Experience/Education:
- High School Diploma or equivalent
- 4+ years of legal compliance experience or related work experience.
Skills and Abilities:
- Working knowledge of applicable benefit and insurance regulations and laws
- Proficient in computers and software skills including but not limited to Microsoft Office products
- Demonstrated organizational skills, problem-solving, analytical skills and detail oriented
- Strong written, oral and telephonic communication skills
- Demonstrated ability to work independently, prioritize workloads, multi-task and manage priorities in order to meet deadlines
- Strong analytical and problem-solving skills
- Ability to work effectively in a team environment
- Ability to work in a detail-oriented environment
What can Imagine360 offer you?
- Multiple Health plan options
- Company paid employee premiums for disability and life insurance
- 20 days PTO to start / 10 Paid Holidays
- 401k Company contribution
- Company paid Short & Long term Disability plus Life Insurance
- Professional development initiatives / continuous learning opportunities
- Opportunities to participate in and support the company's diversity and inclusion initiatives
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Imagine360 is a health plan solution company that combines 50+ years of self-funding healthcare expertise Over the years, we've helped thousands of employers save billions on healthcare. Our breakthrough total health plan solution is fixing today's one-size-fits-none PPO insurance problems with powerful, customized, member-focused solutions.
Imagine360 is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.
**RECRUITMENT AGENCIES PLEASE NOTE: Imagine360 will only accept applications from agencies/business partners that have been invited to work on a specific role. Candidate Resumes/CV's submitted without permission or directly to Hiring Managers will be considered unsolicited and no fee will be payable. Thank you for your cooperation**
