Plan Document Specialist Jr.

📋 Description

• • Join Centivo, a mission-driven health plan dedicated to making affordable, high-quality healthcare accessible to the millions who struggle with healthcare costs. We are seeking a motivated and detail-oriented Junior Plan Documents Specialist to play a crucial role in our delivery team, ensuring the creation and management of accurate and compliant benefit plan documentation.
• • In this remote role, you will work under the guidance of the Plan Documents Manager, collaborating closely with cross-functional teams including Configuration, Implementation, Client Success, and Product. Your contributions will be vital in delivering best-in-class output, enhancing client experience, and ensuring client satisfaction. You may also engage with external stakeholders such as brokers, agents, TPAs, stop loss carriers, and other applicable vendors and clients.
• • As a key member of the delivery team, you will facilitate client onboarding by preparing essential documentations, managing client plan changes, overseeing document management, and performing other duties critical to employer-sponsored welfare benefit plans. This involves a deep understanding and application of federal and employment laws, including:
• • Employee Retirement Income Security Act (ERISA)
• • Internal Revenue Code (Code)
• • Health Insurance Patient Portability and Accountability Act (HIPAA)
• • Medicare Secondary Payer Act (MSP)
• • Consolidated Omnibus Budget Reconciliation Act (COBRA)
• • Affordable Care Act (ACA)
• • Women’s Health and Cancer Rights Act (WHCRA)
• • Your core responsibilities will encompass assisting in client implementation and managing client plan changes. This includes defining clients' benefits and structures to ensure accurate and complete required plan document creation.
• • You will be instrumental in managing the comprehensive benefit plan documentation processes. This involves conducting thorough, section-by-section reviews of prospective conversion plan documents, including critical documents such as Summary of Material Modification (SMM), plan amendments, and Summary of Benefits and Coverage (SBC).
• • Furthermore, you will manage the review of prospective conversion plan documents for Summary Plan Descriptions (SPDs), with support and feedback from Senior team members and/or the Plan Documents Manager as needed. This collaborative approach ensures accuracy and adherence to all regulatory requirements.
• • A significant part of your role will involve drafting, finalizing, and maintaining standard benefit plan documents. This includes SBCs and standard to intermediate-level plan amendments. You will need to identify and understand change requests and their specific requirements, demonstrating the ability to recognize more complex tasks and proactively seek assistance from senior team members or the Plan Documents Manager.
• • You will also be responsible for drafting standard SPDs, or those requiring minimal customization, with guidance from senior team members or the Plan Documents Manager. You will learn to work with and take direction to complete SPDs that may evolve in complexity during the process.
• • Identifying missing information or documentation required for document preparation will be a key task, ensuring a smooth and efficient workflow.
• • You will submit finalized plan documents and any associated changes to stop loss carriers, the Stop Loss team, and the PDM vendor, ensuring all parties have the most up-to-date and accurate information.
• • A critical function is determining and implementing necessary changes to plan documents to guarantee accuracy, ensure seamless coverage, and incorporate any additional updates as required by law or client needs.
• • You will manage and maintain a portfolio of business, primarily focusing on Mid-Market accounts, and/or assigned projects as directed by the Plan Documents Manager, demonstrating strong ownership and accountability.
• • Staying current on the evolving requirements under ERISA, PPACA, and other related laws and regulations as they pertain to plan benefits is essential for this role.
• • You will proactively elevate client issues and concerns to appropriate leadership and/or Client Success team members when necessary, acting as a key point of contact and problem-solver.
• • There may be opportunities to assist in the training of Analysts and newly hired Junior team members, contributing to the growth and development of the team under the direction of the Plan Documents Manager.
• • You may also support client communications, including introductory calls, with the assistance and feedback of Senior team members or the Plan Documents Manager, honing your client-facing skills.
• • Finally, you will perform other miscellaneous projects, assignments, and duties as assigned, showcasing your adaptability and willingness to contribute wherever needed to achieve team and company goals.
• • This role requires a passion and drive for delivering high-quality, accurate documents that directly impact our clients' ability to provide essential benefits to their employees. Your attention to detail and commitment to compliance will be paramount in upholding Centivo's commitment to affordable, high-quality healthcare solutions.