Plan Building Specialist (Hybrid/Remote)

***$750 Sign-On Bonus Available***

Do you envision working for a company that has the expertise of a long-standing industry leader, but the spirit of an entrepreneur? Does the thought of making a real impact motivate and energize you? If so, HPI is the place for you. Join a team that values integrity, flexibility, loyalty, compassion and dedication—we can’t wait to meet you.

What we do

HPI is unique. A respected industry leader that’s been serving customers for over 40 years, we’re known for our innovation and growth. Our experience has given us our expertise, but our forward-thinking, entrepreneurial spirit has given us our strong reputation. As a third-party administrator, we offer a suite of health and benefit solutions to employers. By joining HPI, you’ll contribute to ideas that make a real difference for employers and employees nationwide. There isn’t a challenge we won’t accept and we’re looking for people who have a passion to take it on. Not just a job—a mission.

What you’ll do

The Plan Building Specialist is responsible for new business set up, renewal updates and day-to-day maintenance of data within the Healthware System required to provide accurate claim processing and administration of benefits. This position is also responsible for training on these procedures.

In this role, you’ll also:

• Responsible for installation of new business as well as renewal process for in force business
  • Benefit Plan Building
  • Adjudication Logic Building
  • Maintain Benefit Code, Pend Reason Code, Denial Code, Provider Specialty, EOB Message Code Tables
  • Maintain Benefit Cross Reference Table
  • Maintain Diagnosis Cross Reference Table
  • Build Pricing Contracts as necessary
• Research and resolve Claim processing questions through TRU Workflow Queue
• Research and resolve patient benefit accumulator issues for claims examiners
• Benefit plan testing for new business
• Process refund/void checks in Healthware
• Perform other various tasks that are deemed necessary and equitable by Technical Resource Manager

What you bring

• High School diploma or combination of education, related experience or training
• Plan Building Specialists are required to successfully complete any training sessions as approved by Technical Resource Manager.
• Proficient in Microsoft Office, including Word, Excel, and Outlook
• Ability to prioritize and multitask effectively
• Communicates effectively, both verbally and in writing
• Ability to work both independently and as a member of the team
• Ability to anticipate and understand systems interactions
• Must be detailed, analytical and accurate
• Ability to work within specified timeframe and meet deadlines
• Recognize and maintain confidentiality of work materials as appropriate

Why choose us?

• Our space is a reflection of who we are—innovative, open and collaborative.
• Love to get creative? We do too. Brainstorm in one of our team break-out rooms.
• We think feeling your best is an important factor in producing great work, so we embrace a “smart casual” dress code and work at ergonomic desks.
• Need to reenergize? Take a break to chat in the onsite café, go for a walk on one of the beautiful trails in our office park, or get in a quick workout at one of the campus gyms.
• We offer our employees incredible health coverage, a 401(k), employer-paid disability, EAP, remote and hybrid work arrangements (depending on the position), and quarterly bonuses.
• We’re a people-first company and value giving back to our community. Ask us about our Service & Giving Team and volunteer opportunities.

So, think you want to join the HPI team? We hope to hear from you!

You can read more about us at hpitpa.com/about-us/careers/

EEO/AA/M/F/Vet/Disability