Plan Builder - Work From Home (HB)

Welcome to a team of caring and passionate people who work each day to meet the needs of our members and clients. At Luminare Health (a subsidiary of Health Care Service Corporation), you will be part of an organization committed to offering custom services to self-funded health benefits plans that manage costs – without compromising benefits – by offering innovative solutions, flexibility, transparency and customer support. This is an exciting time to join our team and enhance our culture that emphasizes caring, diversity and inclusion, mutual respect, collaboration and service to our communities. 

Job SummaryThe primary responsibility of this position is to build health benefit plans in our claims administration system to adjudicate benefits according to those written into each Summary Plan Description. Plan Builders set up files from health benefit plans which have been developed and enter the necessary codes and parameters into the system to achieve timely and accurate claim processing. This position tests all new benefit setups to verify system payments are according to benefit plan design and is also responsible for accurately maintaining and updating existing plans.

Required Job Qualifications:

• Minimum of 1 -2 years’ experience in a Claims/Customer Service/Benefits environment. 
• Working knowledge of PowerSTEPP
• Strong math and analytical skills
• Ability to conceptualize
• Excellent problem solving and organizational skills with attention to detail and the ability to manage multiple priorities under strict timeframes
• The ability to work reliably as part of a larger team
• Commitment to exceed quality standards and produce exceptional products and services
• Must possess strong verbal and written communication skills with the ability to explain complex processes and procedures
• An inherent customer service mindset is vital in this position as is a superior …