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International Medical Group Benefit Plan Builder in Indianapolis, Indiana

IMG is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, ethnicity, national origin, religion, gender, gender identity or expression, sexual orientation, genetic information, disability, age, veteran status, and other protected statuses as required by applicable law.

As one of the world's top International Medical Insurance companies, IMG helps individuals and companies of all sizes. Every second of every day, vacationers, those working or living abroad for short or extended periods, people traveling frequently between countries, and those who maintain multiple countries of residence use our products to give themselves global peace of mind®

We are looking to grow our teams with people who share our energy and enthusiasm for creating the best experience for travelers.

JOB DETAILS

  • Location: Indianapolis, IN

JOB SUMMARY

The Plan Builder will be part of the International Claims department and will be responsible for extracting benefits from certificate wordings and implementing the benefits into the claims system. The Benefit Plan Builder solicits and assesses internal customer feedback to enhance continuous quality improvement on the implementation process (i.e. system tools, resources, etc.); perform benefit plan audits and provide guidance to help resolve claims issues; and monitors workflow with outside vendors and assists in resolving any issues that arise.

DUTIES AND RESPONSIBILITIES

  • Analyze, interpret, and implement a variety of certificate documents

  • Monitor, analyze, and provide support for EDI files and reporting

  • Respond to written and oral inquiries from internal staff

  • Identify process improvement opportunities and recommend system enhancements

  • Conduct investigation of claims, perform adjustments, and communicate with outside vendors

  • Testing of benefit plan designs to ensure accuracy within the system

  • Work with auditors and trainers to ensure processes are understood correctly

  • Prioritize to ensure timely implementations

  • Ensure department practices meet or exceed company's processing standards, procedures, and service level agreements

  • Provide an internal environment of team work and promote positive communications with all departments

  • Work closely with IT, Business Analysts, and Project Managers

  • Report status of activities and on-going projects to immediate Team Leader

  • Work directly with Account Managers on policy interpretation and implementation

QUALIFICATIONS

  • High school diploma / GED / or Equivalent

  • Minimum of 2 years of medical claims examining experience

  • Strong analytical, problem solving, and critical thinking skills along with the ability to work independently

  • Excellent verbal and written communication skills with proven ability to communicate clearly and concisely

  • Remain flexible yet focused during stressful situations

  • Be highly organized and able to quickly prioritize multiple assignments with high quality results

  • Documentation skills and data entry skills

  • Computer skills and proficiency in operating common office equipment

PREFERRED SKILLS

  • Familiar with Excel, SharePoint, .CSV, and .EDI

  • Medical terminology, CPT procedures, and coding with ICD-9 and ICD-10

PERKS

  • Comprehensive benefits package including Medical/RX/Dental/Vision insurance

  • 401k Plan with company match

  • On site fitness center

  • Casual dress environment

  • Tuition reimbursement plan

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