Document Specialist

Madison, Wisconsin
Administrative & Support Services
Job Type
US$ 15.00 per hour, $15 per hour + none
Ref. Number
Spude, Joshua, Spherion
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Job Description

This position will be responsible for the creation and posting of Member Certificates and Summary of Benefits and Coverage (SBC) documents among other member facing documents. The position would also be responsible for the build and quality assurance of new and renewing benefit plans in our core administrative systems.

Essential Job Duties:
1. Define, create, test and maintain detailed benefit plan designs. This includes the creation of templates utilizing keywords and coverage to assign financial liabilities to benefit plans within the claims administration system.
2. Utilizing excel high level capabilities, create and maintain interactive job aides that support the build and quality assurance of benefit plan builds and benefit narratives. Participate in providing technical/research support and analysis for benefit design in support of company initiatives.
3. Provide expert knowledge and recommendations related to detailed benefit plan builds.
4. Create and analyze reports to support and complete quality assurance activities against detailed plan designs to insure accuracy prior to promotion to production.
5. Create member facing documents including Summary of Benefits and Coverage, Certificate of Coverage, and Schedule of Benefits utilizing MS office applications - high level excel mappings and Word mail merging for the purpose of member distribution.
6. Create and maintain templates for the Certificate of Coverage and Summary of Benefits and Coverage in conformance to the Wisconsin Office of Commissioner of Insurance filings.
7. Publish member facing documents to the Member Document Center
8. Define, configure, test and maintain benefit narratives for Electronic Data Interchange 270/271 transactions.
9. Assist with automated files and interfaces related to benefit narratives.

Working hours: M-F 8 to 5

1. High school diploma or equivalent.
2. 2 or more years of experience within a health insurance, health plan administration, claims operations, benefit administration or benefit policy setting or technology setting.
3. Claims operations knowledge.
4. Demonstrated process development and improvement skills.
5. Strong organizational and communication skills.
6. Highly proficient in MS Office applications, specifically Microsoft Excel and Microsoft Word.
7. Knowledge of medical terminology, medical coding and common claims adjudication practices.
8. Ability to maintain semi-technical documentation.
9. High degree of attention to detail and analytical work.

Spherion has helped thousands of people just like you find work happiness! Our experienced staff will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temp-to-perm or direct hire opportunities, no one works harder for you than Spherion. EEO Employer: Race, Religion, Color, National Origin, Citizenship, Sex, Age, Disability, Ancestry, Veteran Status, Genetic Information, Service in the Uniformed Services or any other classification protected by law.

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