Plan Builder - Remote Position at Auxiant

About the Role

We're hiring a Plan Builder to join Auxiant's remote team. As a Plan Builder, you will play a crucial role in interpreting complex health benefits information and ensuring accurate data input into our claims processing system. This position offers a unique opportunity to contribute to a progressive and fast-growing independent third-party administrator (TPA) specializing in self-funded employee benefit plans.

What You'll Do

• Analyze and configure group benefit health plans to meet client needs.
• Demonstrate organized and effective project management skills in a remote setting.
• Participate in internal and external meetings regarding plan designs and coding.
• Improve system auto adjudication through claims logic coding and plan design.
• Create and modify summaries of benefits for each new or changed plan.
• Cross-audit plan documents for benefit accuracy.
• Answer processor questions regarding benefits and plan build.
• Suggest improvements in processes to enhance efficiency.

Requirements

• 2+ years of experience in the self-funded health insurance industry.
• Experience in benefit programming and knowledge of Trizetto’s Qiclink claims software.
• Strong knowledge of health insurance terminology and coding systems (e.g., CPT, ICD-10).
• Excellent attention to detail and document interpretation skills.
• Effective communication skills and collaboration ability.
• Ability to work in a fast-paced environment and meet deadlines.

Nice to Have

• Experience with project management tools.
• Knowledge of regulatory compliance in health insurance.
• Familiarity with data analysis techniques.

What We Offer

• Comprehensive medical, dental, and vision coverage.
• Flexible Spending Account options.
• Gym Membership Reimbursement.
• Life Insurance, Long-Term Disability (LTD), and Short-Term Disability (STD).
• 401K plan with company matching.
• 3 weeks of vacation and 9 paid holidays per year.
• Casual dress code promoting a comfortable work environment.