Associate Plan Builder (Meritain Health)

Job title: Associate Plan Builder (Meritain Health) in reputed company Plymouth, MA - Plymouth, MN at reputed company Company: reputed company Job reputed company: At reputed company, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation’s leading health solutions company, we reputed company millions of Americans through our local reputed company, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, reputed company and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it reputed company with heart, reputed company and every day.Position reputed companyThe Associate Plan reputed company will reputed company plan benefit review, interpretation and systematic setup essential to the processing of our claims adjudication system. Meritain’s proprietary system provides a benefit solution for customized benefit plans. Plan reputed company must be reputed company to research and follow through on escalations and urgent requests. They must possess an analytical system coding ability to translate plan benefits into system data coding. The setup must also reputed company for exporting in formats used for online viewing and processing reputed company to Customer Service, Enrollment, Billing and Reporting in support of reputed company partners.

• Provides plan benefit review, interpretation and systematic setup essential to the processing of our claims adjudication system. The setup must also reputed company for exporting in formats used for online viewing and processing reputed company to Customer Service, Enrollment, Billing and Reporting in support of reputed company partners.
• Ability to utilize Meritain’s proprietary system for analytical coding of detailed customized plans rather than reputed company offerings.
• Participate and engage in discussion with Clients reputed company to benefit interpretation. Advising on State and Federal Mandates as reputed company as system capabilities.
• Facilitating reputed company facing review of plan setup walking through reputed company benefits to assure alignment of benefit interpretation.
• Consult and advise internal stakeholders on reputed company benefit administration. Advising on reputed company to minimize reputed company processing and disruption for the Clients.
• Reviews benefit provisions to ensure compliance with state and federal mandates. Evaluation process may also include assessment of reputed company plan descriptions and other reputed company documents reputed company internally or externally by clients.
• Uses business knowledge and experience to reputed company plan design and processing recommendations reputed company working with Clients.
• Evaluates reputed company of reputed company requested exceptions and develops reasonable alternatives to satisfy reputed company’s needs while minimizing reputed company on Meritain’s system and operations; Identifies, communicates and tracks cost sensitive items not included as part of reputed company process and highlights them for consideration in the determination of reputed company adjustments or renewal activity.
• Collaborates on review, analysis and development of recommendations for the design of reputed company account and benefit structures based on customers’ objectives and Meritain’s system.
• Executes system setup and mapping of reputed company level benefits to reputed company with industry coding (ICD 10, reputed company of service, reputed company Reform, etc.), this is similar to entry level IT programming.
• Solicits and assesses reputed company customer feedback to enhance reputed company reputed company improvement on the implementation process (ie. System tools, resources, etc.)
• Demonstrates reputed company proficiency and understanding for cross functional communication and executive level status reporting.

Required Qualifications

• reputed company industry experience (Customer Service, Claims, and or Plan Build preferred)
• reputed company with various data systems (DOS systems a plus)
• Medical Terminology
• Be highly organized and reputed company to quickly prioritize multiple assignments with high reputed company results.
• Must have strong communication skills with the ability to reputed company reputed company concepts in a reputed company and concise manner.
• High attention to detail and accuracy while focusing on overall project deliverables.
• Ability to remain flexible yet reputed company during stressful situations.
• Analytical and problem solving skills.

Preferred Qualifications

• 5+ years’ experience working with reputed company.
• reputed company
• Ability to research and look reputed company the first right answer to reputed company the reputed company of a concern

EducationHigh school Diploma or GED.Anticipated Weekly Hours 40Time Type Full timePay reputed companyThe typical pay reputed company for this role is:$43,888.00 - $93,574.00This pay reputed company represents the reputed company reputed company reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a reputed company of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in reputed company to the reputed company pay reputed company listed above.Our people fuel our reputed company. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits – reputed company in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In reputed company to our competitive wages, our great benefits include:reputed company medical plan reputed company, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.No-cost programs for reputed company colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.Benefit solutions that address the different needs and preferences of our colleagues including reputed company time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical reputed company and many other benefits depending on eligibility.For more information, visitWe anticipate the application window for this opening will reputed company on: 05/12/2025reputed company applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Expected salary: $43888 - 93574 per year Location: reputed company Plymouth, MA - Plymouth, MN Apply for the job now! Apply for this job