Welfare Benefit Plan Specialist

Lifetime Benefit Solutions•Rochester, NY

12d

About The Position

Under the direction of assigned management, the Welfare Benefit Plan Specialist drafts, reviews, and edits welfare benefit plan documents, summary plan descriptions (SPDs), summaries of benefits and coverage (SBCs), plan amendments, and summaries of material modifications (SMMs). The role provides general benefit plan consulting to internal clients on plan design, compliance, and documentation. It also supports external clients with Form 5500 preparation and filing assistance and access to non-discrimination testing resources. The position coordinates with internal departments to implement plan designs, responds to client questions, interprets plan documents for internal clients, and maintains accurate client, billing, and communications records. Regular and reliable attendance is expected. The role may require travel across the Health Plan service region for meetings or training. Remote work may be available on a case-by-case basis. The role supports the Lifetime Healthcare Companies’ mission and values, complies with its Corporate Code of Conduct and privacy policies, and maintains a high regard for member privacy. Compensation is listed as Grade N7, with a range of $23.75 to $37.70; actual compensation depends on factors including experience, skills, education, budget, and internal equity. The total rewards package may include group health and/or dental insurance, a retirement plan, a wellness program, paid time away from work, and paid holidays.

Requirements

Five or more years of claims processing experience, including knowledge of ICD-9/10 and CPT coding and claim adjudication processes, paralegal experience, or related experience; alternatively, an associate degree in paralegal studies or a related field and two or more years of employee benefits, paralegal document review, or similar experience.
Strong analytical ability and attention to detail.
Good organizational skills and the ability to multitask, work independently, prioritize assignments, and handle confidential information with discretion.
Knowledge of relevant provisions of ERISA, the Internal Revenue Code, HIPAA, COBRA, and Health Care Reform.
Excellent oral and written communication skills.
Willingness and ability to learn welfare benefit plan regulatory requirements and stay up to date with them.
Knowledge of Microsoft Office applications.
Ability to work for prolonged periods sitting and/or standing at a workstation and working on a computer.
Ability to hear, understand, and speak clearly while using a phone, with or without a headset.
Ability to travel across the Health Plan service region for meetings and/or trainings as needed.

Responsibilities

Draft, review, and edit welfare benefit plan documentation according to defined standards and processes.
Prepare and review welfare benefit plan Form 5500s and assist external clients with filing as requested.
Provide external clients access to the non-discrimination testing website and assist with questions and test failures.
Establish and maintain client files, billing records, and related information.
Coordinate with internal departments to implement plan design.
Respond to internal and external client inquiries about plan design and plan documentation.
Attend client meetings as necessary.
Serve as a resource to internal clients on the interpretation of welfare benefit plan documentation.
Maintain accurate records and files of written materials and communications related to plan design and documentation.
Support the company’s mission and values, adhere to the Corporate Code of Conduct, and lead according to the Lifetime Way values and beliefs.
Protect member privacy in accordance with corporate privacy policies and procedures.
Maintain regular and reliable attendance.
Perform other functions as assigned by management.