Plan Analyst

Imagine360

1d • Remote

About The Position

Imagine360 is seeking a Plan Analyst to join the team! This position constructs and implements new plan documents in the claims system. This position maintains a comprehensive understanding of the plan document(s) under their scope of responsibility.
Position Location:100% remote

Requirements

• High school diploma or equivalent required
• 3+ years of Claims Examiner and/or plan building experience required
• Demonstrated organizational skills, problem-solving, analytical skills and detail oriented
• Strong written and oral communication skills
• Working knowledge of computers and software including but not limited to Microsoft Office products
• Demonstrated ability to work independently, prioritize workloads, multi-task and manage priorities in order to meet deadlines.
• Proficient 10-key and typing skills

Nice To Haves

• Bachelor's degree preferred
• Familiarity with VBA, Javelina, and/or GBAS system preferred

Responsibilities

• Plan building
• Designs and implements system set up in accordance to plan document description.
• Builds new groups and adjusts system per plan amendments in Claims system.
• Documents applicable changes in related systems.
• Determines benefits using ICD, CPT, HCP and Rev Codes in association with provider specialty, age, relationship, place of service and PPOs.
• Updates accumulators for newly implemented groups.
• Plan Document Language
• Ensures plan language conforms to the group's intent and claims build is properly constructed according to document.
• Interprets and explains plan document language and plan designs for various EBMS departments.
• Customer Service
• Receives and resolves internal inquiries regarding plan document language and design.
• Provides timely and thorough follow up with, internal and external customers.
• Appropriately escalates difficult issues up the chain of command.
• Acts as a role model in demonstrating the core values in customer service delivery.
• Trains and mentors new employees as assigned.
• Quality Assurance
• Attends and participates in committee meetings and training sessions.
• 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 staff and cross-departmentally to improve or streamline procedures.
• Assists the Claim Department in performing plan design testing for new clients and renewing clients to assure quality output from the system.

Benefits

• Multiple Health plan options
• Company paid employee premiums for disability and life insurance
• Parental Leave Policy
• 20 days PTO to start / 10 Paid Holidays
• Tuition reimbursement
• 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

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED