Relation Insurance Services
You deserve more than an insurance company. You deserve a partner, a teammate, a friend in the business.
Health Plan Compliance Specialist
Location
Oklahoma
Posted
43 days ago
Salary
Not specified
Seniority
Mid Level
High School2 yrs expExperience acceptedEnglish
Job Description
• Creates, maintains, and updates PHIA-regulated Summary Plan Descriptions (SPDs) and Plan Documents for ERISA and non-ERISA health plans
• Produces Summaries of Benefits and Coverage (SBCs) in accordance with federal and state compliance requirements and ensure alignment with unique client plan design
• Manages plan renewals and drafts plan amendments
• Supports the production and delivery of 80+ plan documents per month
• Participates in client implementation meetings to review benefit outlines
• Collaborates with cross-functional teams (e.g., implementation, compliance, operations)
• Conducts quality reviews to confirm plan documents accurately reflect approved benefit designs and regulatory requirements
• Maintains organized documentation records and version control
• Assist with regulatory audits, client compliance inquiries and review related to the plan document
• Coordinate with vendors to support required federal and state health plan filings
• Conduct the preparation, validation and submission of data and documentation for mandated filings listed above
Job Requirements
- High School diploma or equivalent
- Bachelor’s degree in Business, Health Administration, Public Policy, English, or related field; equivalent experience preferred
- Strong writing, editing, and proofreading skills with attention to detail
- Strong knowledge of employee benefits and health plan concepts (medical, Rx, dental, vision, HSA/HRA/FSA)
- Working knowledge of the laws and regulations associated with HIPAA
- Strong knowledge of health plan design & terminology
- Willingness to adhere to all principles of confidentiality
- Proficiency with Microsoft Word (templates/styles), Excel, and Adobe Acrobat
- Ability to manage multiple deadlines in a fast-paced, high-volume environment
- Ability to work independently and follow through on deliverables
- Excellent communication and collaboration skills
- Proficiency with Microsoft Office (Word styles/templates, Excel), Adobe Acrobat, and redlining tools
- 2+ years of experience working for a Third Party Administrator, health insurance broker, carrier, or benefits consulting firm in a role involving benefit plans, client implementation, compliance, or plan document preparation preferred
- Familiarity with plan document generation platforms or template libraries preferred
- Exposure to ERISA, ACA, HIPAA, COBRA, MHPAEA, and state benefit mandates preferred
- Familiarity with SBC templates and plan document generation platforms preferred
- A Life Accident and Health License from state of domicile is preferred.
Benefits
- Competitive pay
- A safe and healthy work environment provided by our robust benefit program including family health and wellness programs
- 401K
- employee assistance programs
- paid time off
- paid holidays
Related Guides
Related Categories
Related Job Pages
More Compliance Jobs
Contract Compliance Analyst III
Exact SciencesChanging the way we think about detecting and treating cancer.
Compliance43 days ago
Full TimeRemoteTeam 5,001-10,000Since 1995H1B Sponsor
Contract Compliance Analyst facilitating revenue pull-through at Exact Sciences
Compliance Manager – Branch Inspections
TransamericaTransamerica is a holding company for a number of life insurance firms and investment companies that offer services across the country. As an employer, the comp
Compliance43 days ago
Full TimeRemote
Manager overseeing branch inspection operations for Transamerica Financial Advisors.
Compliance43 days ago
Full TimeRemoteTeam 10,001+Since 1961H1B Sponsor
Director overseeing Insurance Product Compliance for Humana
Compliance43 days ago
Full TimeRemoteTeam 10,001+Since 2010H1B No Sponsor
Director, Global Regulatory Lead managing strategies for cancer treatment development
