Welfare Benefit Plan Specialist

company • Town of Kirkland, NY

6d • $24 - $38

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 (PDs/SPDs), summaries of benefits and coverage (SBCs), plan amendments, and summaries of material modifications (SMMs). The position provides general benefit plan consulting services to internal clients regarding benefit plan design, compliance, and documentation.

The role prepares and reviews welfare benefit plan Form 5500s and may assist external clients with filings. It also supports clients using the non-discrimination testing website, maintains client files and billing information, coordinates implementation of plan designs with internal departments, responds to client inquiries, attends meetings as needed, and advises internal clients on interpreting welfare benefit plan documentation. The position maintains accurate records and communications, protects member privacy, and supports the company’s mission, values, and Code of Conduct. Regular and reliable attendance is required, and other duties may be assigned by management.

Requirements

• At least five years of claims processing experience, including knowledge of coding (ICD-9/10, CPT) and claim adjudication processes, paralegal experience, or related experience; alternatively, an associate degree in paralegal studies or a related field and at least two years of employee benefits, paralegal document review, or similar experience.
• Strong analytical ability and attention to detail.
• Good organizational skills and 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 about welfare benefit plan regulatory requirements and keep up to date with them.
• Knowledge of all Microsoft Office applications.
• Ability to sit and/or stand at a workstation for prolonged periods and work 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 with access to the non-discrimination testing website and assist with questions and test failures.
• Establish and maintain requisite client files, billing records, and information.
• Coordinate implementation of plan design with internal departments.
• Respond to internal and external client inquiries concerning plan design and documentation, and attend client meetings as necessary.
• Act as a resource to internal clients regarding interpretation of welfare benefit plan documentation.
• Maintain accurate records and files of written materials and communications regarding plan design and documentation.
• Support the Lifetime Healthcare Companies’ mission and values, adhere to the Corporate Code of Conduct, and lead according to Lifetime Way values and beliefs.
• Maintain member privacy in accordance with corporate privacy policies and procedures.
• Maintain regular and reliable attendance.
• Perform other functions as assigned by management.

Benefits

• Group health and/or dental insurance may be included in the total rewards package.
• Retirement plan may be included in the total rewards package.
• Wellness program may be included in the total rewards package.
• Paid time away from work may be included in the total rewards package.
• Paid holidays may be included in the total rewards package.

What This Job Offers

• Job Type: Full-time
• Education Level: Associate degree