Benefit Contrct Anlyst
$62,900–$85,100 year
HybridSalt Lake City, Utah, United States or Portland, Oregon, United States
Job Summary
Develop and file regulatory benefit materials, including contracts, policies, and Summary of Benefits and Coverage documents, for individual, small group, and large group plans. Collaborate with Legal and Product teams to draft benefit language, coordinate document production, and manage regulatory submissions to state insurance divisions. Analyze objections from insurance divisions, negotiate response language, and oversee resubmission functions to ensure timely approval. Cultivate relationships with internal teams and external customers while researching benefit interpretations and maintaining compliance with federal and state regulations. Requires a bachelor's degree and three years of experience in healthcare administration or communications.
Required Qualifications
- Bachelor's degree in healthcare, English, business or health care administration, communications
- 3 years work-related experience or equivalent combination of education and experience
- Significant organizational skills with a demonstrated ability to prioritize, coordinate and implement multiple projects within varied or simultaneous time constraints and deadlines
- Clear and concise verbal and written communication skills
- Tactful and persuasive negotiation skills
- Ability to work independently, exercise sound judgment, and develop collaborative and effective working relationships with internal and external business partners
- Ability to fearlessly take on new challenges in a changing insurance and corporate environment
- Comprehension and mastery of the drafting of all aspects of the regulatory health benefit documents for fully-insured lines of business and custom groups
- High proficiency in Windows applications, including Word
- Ability to work in high-pressure circumstances with multiple concurrent projects involving multidisciplinary, distinct tasks, and a proven ability to initiate and independently produce detailed and highly accurate work
- Ability to work with minimal supervision and assume increasingly complex responsibilities
- Knowledge of the health insurance industry, including benefit design and compliance concerns
- Understanding of federal laws and guidelines, such as the Affordable Care Act (ACA), COBRA, HIPAA and state health insurance code and regulations
- Ability to travel locally or out of state
- Ability to work overtime
- Ability to work outside normal hours
- Access to a wired internet connection that is not satellite or cellular with a minimum upload speed of 5Mb and a minimum download speed of 10 Mb
- Access to a personal mobile device to set up Multi-Factor Authentication (MFA)
- Ability to pass a background check
- Ability to comply with a drug and tobacco-free workplace policy
Desired Qualifications
- Experience with AI tools and technologies to enhance productivity and decision-making in professional settings
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