Benefits Plan Analyst

The Benefits Plan Analyst will support our System Configuration and Plan Build Team. This role is responsible for reviewing, interpreting, and translating complex benefit plan documents into accurate, actionable materials for internal plan building and configuration teams. The ideal candidate will have experience working with self-funded healthcare plans and a deep understanding of benefit plan language. Responsibilities: Analyze benefit plan documents to extract and translate benefit provisions into internal documentation used for plan builds. Create clear, comprehensive plan summaries and benefit mapping documents for new groups and renewals. Collaborate with internal teams (Plan Build, Implementation, Eligibility, Auditing) to gather requirements and clarify plan setup needs. Review and audit Summary of Benefits and Coverage (SBC) documents to ensure consistency with plan intent. Identify and resolve discrepancies or missing information in plan documentation, escalating issues as needed. Serve as a subject matter expert on plan language and documentation standards. Support continuous process improvement efforts related to benefit documentation and internal workflows. Qualifications: Minimum of 2 years of experience in benefit plan analysis, medical claims, or related healthcare operations — preferably within a TPA or self-funded insurance environment. Strong ability to read and interpret complex benefit plan documents. Familiarity with benefit plan design concepts and terminology, including ICD-10, CPT coding, and healthcare regulations. Exceptional written communication and documentation skills. Detail-oriented with strong analytical and problem-solving capabilities. Comfortable working independently and cross-functionally in a remote, fast-paced environment.