Plan Builder

Plan Builder Scottsbluff, NE 69361 $37,000

• $50,000 a year
• Full-time $37,000
• $50,000 a year
• Full-time The Plan Builder is responsible for configuring, building, and maintaining self-funded health insurance plans for employer groups administered by RCI.

This critical role translates benefit designs, employer elections, and regulatory requirements into accurate system configurations that support enrollment, eligibility, claims adjudication, and reporting. Qualifications and Skills High school diploma or GED 2+ years of experience with a Third-Party Administrator (TPA), claims adjudication, or health plan configuration is required. Strong understanding of self-funded health plans, benefit coding, healthcare regulations and compliance standards. Understanding of ERISA plan documents, Summary of Benefits and Coverage (SBCs), and Summary Plan Descriptions (SPDs). High attention to detail and ability to manage complex benefit configurations. Strong analytical, problem-solving, data validation and documentation skills. Proficiency with plan-building systems, benefits administration platforms, or databases. What You'll Do Build and configure medical, dental, vision, and ancillary benefit plans for self-funded employer groups. Translate benefit summaries, plan documents, and employer elections into system-ready configurations. Configure eligibility rules, cost-sharing structures, accumulators, networks, and coverage tiers. Ensure plan setups comply with federal and state regulations (ACA, ERISA, HIPAA, COBRA, CMS where applicable). Collaborate with sales, implementation, account management, claims, and compliance teams. Perform quality assurance testing to ensure accurate claims processing and member experience. Update and maintain plans for renewals, mid-year changes, and regulatory updates. Document plan configurations, changes, and approvals for audit and reference purposes. Develop and implement strategies and processes for plan building. Identify and resolve plan setup discrepancies that may impact enrollment or claims. Requirements

ESSENTIAL TECHNICAL/MOTOR SKILL

Demonstration of prior work experience in the operation of standard office computer software. Prior data entry computer skills essential. Ability to understand the operation of the in-house computer system and how it relates to the operation of business. Ability to use various office machines.

PEOPLE SKILLS

Excellent interpersonal and communication skills.

ESSENTIAL PHYSICAL REQUIREMENTS

Able to move throughout the office. Ability to lift and transport less than 20 pounds.

ESSENTIAL MENTAL ABILITIES

Able to work independently, managing multiple tasks, analyzing, and assessing while following established policies and procedures and making decisions on the steps to take. Ability to research compliance requirements related to state and federal regulations. Ability to work under high levels of stress and meet deadlines. Ability to read for extensive periods of time and interpret plan documents.

TRAVEL:

None.

EXPOSURE TO HAZARDS

None. An equal opportunity employer committed to creating an inclusive workplace.

Job Type:

Full-time Pay:

$37,000.00

• $50,000.

00 per year

Benefits:

401(k) Dental insurance Health insurance Paid time off Vision insurance

Experience:

plan building: 2 years (Preferred) Benefits administration: 2 years (Preferred)

Work Location:

In person