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Plan Document Specialist

2 months ago

Sandton, South Africa HR Studio Full time
About the Role

At HR Studio, we're seeking an experienced Plan Document Specialist to join our team. As a key member of our team, you will play a crucial role in creating, maintaining, and updating our business and renewal business plan documents.

Key Responsibilities
  • Collaborate with the Plan Document Writer to research and amend medical plan documents, including the Summary of Benefits & Coverage (SBC), Summary Plan Description (SPD), Benefit Plan Descriptions (BPD), and Summary of Material Modifications (SMM) or Summary Plan Description (SMR).
  • Assist with incorporating new language to support legislative or administrative changes.
  • Oversee the inventory and status of documents from initial need through publication, including future edits. Ensure deadlines are met.
  • Modify benefit design and information using templates or existing documents.
  • Submit completed documents or projects within Service Level Agreement (SLA) timeframes.
  • Work closely with internal customers to ensure the correct documentation is in place.
  • Investigate plan document questions using internal and external sources to validate responses and address documentation issues.
  • Maintain accurate data across various platforms for a range of end users.
  • Write procedure documentation in alignment with business goals and legal requirements.
  • Provide timely documentation to users to help them understand and reference how plan changes impact the system.
  • Publish, proofread, and edit documents to ensure ongoing compliance and quality.
  • Ensure data accuracy across various platforms.

Requirements
  • Matric
  • Bachelor's degree or equivalent work experience preferably in a healthcare or benefits TPA setting.
  • 2+ years of experience in claims handling, quality control or plan document experience in a healthcare setting.
  • Familiarity with, and an understanding of the differences in, each type of Plan Document: SBC, SPD, BPD, SMM, and SMR.
  • Knowledge of medical procedure terminology preferred.
  • You can maintain confidentiality and exercise discretion in handling sensitive information.
  • You are proficient in Microsoft Office

Working Hours
2pm - 11pm