KBA is a privately owned company with a family atmosphere and supportive leadership, and we take an active role in our local communities with corporate sponsorships and community outreach programs. Employees continue to vote KBA as a Top Workplace year after year! Founded in 1979 as a full-service group benefits administration firm specializing in self-funded medical plans. One of the country's largest independently owned third party administrators, supporting a wide variety of group benefit plans. Our Mission: To create happy customers who renew by improving upon our successful track record of applying patented, proven, creative solutions to the reduction of healthcare costs while improving people's health through high quality, cost-effective care.
Plan Builder
Location
United States
Posted
11 days ago
Salary
0
Seniority
Mid Level
Job Description
Plan Builder
Key Family of Companies
Role Description Key Benefit Administrators is currently seeking a Plan Builder to join the team. We are excited to speak to qualified candidates about this work from home opportunity. This is a remote position and includes a comprehensive benefit package and competitive salary! The Plan Builder is responsible for analyzing medical plan documents to accurately build and maintain our clients' plan of benefits using the VBA processing system for the most automated and correct adjudication of claims. Essential Duties and Responsibilities: - Review plan documents, amendments, policies and mandates and coordinate with other departments' staff to ensure difficult, detailed benefit levels within documents can be accurately coded. - Provide feedback on difficult benefits that require manual intervention and suggest changes that would auto adjudicate. - Accurately code/update coding on plans based on the document/amendment. - Assist in auto adjudication of claims by coding benefits that require no manual intervention. - Thoroughly test all changes for renewals, new plans, and amendments. - Create and maintain group documentation to ensure the correct processing of claims when manual intervention is required. - Analyze and take appropriate action to correct problems identified through claim referrals. - Perform other work-related duties as assigned by manager. Qualifications - A minimum of 2 or more years of comprehensive experience with the building and coding of medical, dental and vision plans required. - A minimum of 2-3 years' experience on the VBA system required. - Must have strong analytical skills and knowledge of CPT, HCPCS, and ICD-9 coding terminology. - Must have general knowledge and be familiar with federal laws affecting self-funding. - Proficient in the use of the Excel and Word programs. - Must be accountable and able to multi-task, work well under pressure, prioritize and organize work. - Must be able to work professionally, and respectively with other team members and other departments. - Ability to communicate professionally and effectively both orally and electronically. Company Description We are on a mission to improve health and stabilize insurance costs for local communities. KBA was founded in 1979 as a privately owned full-service group benefit administration firm specializing in self-funded medical plans and is now one of the country's largest independently owned third party administrators. We pride ourselves on having supportive leadership, a family atmosphere, and a high performing culture - ask our employees - they have agreed that we are a Top Workplace since 2013.
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