Benefits Analyst

Benefits Analyst
Wheeling, WV
Full-Time
Sales & Account Management
Director of Department

  • This position will be responsible for the accurate and timely implementation, building and maintenance of new and existing benefit plans in the claims system in a way that maximizes the potential to automatically adjudicate claims.
  • This position will also work with clients and AEs to recommend benefit plan designs and resolve plan design issues, and for developing and reviewing coverage summary documents for review with team and clients.    

  1. High School graduate or equivalent;
  2. Self-starter and works independently;
  3. Detail oriented with strong analytical skills;
  4. Ability to prioritize and meet deadlines;
  5. Maintains confidentiality;
  6. Good communication skills;
  7. Proficient in Microsoft Office products (Word, Excel, Power Point);
  8. Easily adapts to changes in work requirements.

  1. Bachelor's degree from an accredited college or university;
  2. Previous experience with claims processing and interpreting benefit plan design and summary plan descriptions;
  3. Knowledge of CPT and ICD-9/ICD-10 coding and medical terminology;
  4. Knowledge of all claim types and coverage types for medical and hospital claims;
  5. Knowledge of prescription coding (NDC);
  6. Knowledge of state and federal regulations regarding claims payment guidelines;
  7. Broad understanding of health benefits and plan designs;
  8. Exceptional teamwork abailites, flexibility, organiation and positive can do attitude.

Employment Documents

EEO

Or, if you are interested in a fast-paced career with us, please send resume with salary requirements to:

HR Department 
1110 Main Street
Wheeling, WV 26003-2704
hr@healthplan.org