Plan Coder

Job Summary

A company is looking for a Plan Coder.

Key Responsibilities

• Code new business and plan changes, ensuring compliance with summary plan descriptions
• Verify accuracy of plans in the claims management system and respond to work orders regarding plan issues
• Document processes, identify inefficiencies, and implement process improvements annually

Required Qualifications

• BS/BA degree in computer science, business, or related field
• Minimum of two years of experience in pharmacy, medical, or dental claims auditing
• Ability to analyze and interpret group health benefits provisions and administrative policies
• Advanced skills in Microsoft Office applications, particularly in word processing and spreadsheets
• Experience in maintaining a HIPAA-compliant workstation and ensuring data protection