Plan Document Specialist

Job Summary:

The Plan Document Specialist supports the Document Team in the creation, maintenance, and revision of plan documentation for both new and renewing business. This role is responsible for drafting and updating key materials such as Summary of Benefits & Coverage (SBC), Summary Plan Descriptions (SPD), Benefit Plan Descriptions (BPD), and Summaries of Material Modifications or Reductions (SMM/SMR). The specialist ensures all documents are accurate, compliant, and aligned with client and regulatory requirements.

• Support Plan Document Writers by preparing and updating medical benefit plan documents such as Summary of Benefits & Coverage (SBC), Summary Plan Description (SPD), Benefit Plan Descriptions (BPD), Summary of Material Modifications (SMM), and Summary of Material Reduction (SMR).
• Assist with incorporation of pre-approved document language changes resulting from administrative or legislative updates.
• Track document inventory and status, monitoring timelines from intake through delivery, ensuring deadlines are met.
• Edit and format plan documents using established templates or existing documents with guidance from senior team members.
• Submit assigned document updates and support tasks within defined Service Level Agreement (SLA) time frames.
• Collaborate with internal stakeholders to verify document details and ensure accurate implementation of plan information.
• Perform research to support Plan Document Writers, using internal systems and regulatory resources to validate content accuracy.
• Maintain data integrity across multiple platforms for internal use and recordkeeping.
• Contribute to the development and maintenance of team procedure guides under direction of senior staff
• Provide general documentation support and coordination to help ensure document readiness for internal and external use.

Required Knowledge,

Skills and Abilities

• Bachelor’s degree or equivalent work experience, preferably in a healthcare or benefits TPA setting.
• 2+ years of experience in a healthcare, insurance, claims handling, quality control or plan document role. TPA business and process knowledge preferred
• Strong familiarity with medical and employee benefit terminology, including a clear understanding of the distinctions between various plan documents such as SBCs, SPDs, BPDs, SMMs, and SMRs.
• Ability to make sound decisions by proactively identifying issues, gathering and analyzing information, and effectively utilizing available resources; manage competing priorities
• Meticulous approach to reviewing and producing accurate content while adhering to structured processes and standardized templates.
• Willingness to work outside of regular business hours especially during peak periods, such as the fourth quarter, to address client needs and support project timelines.
• Solid working knowledge of standard computer applications including MS Word, Excel, Outlook, and PowerPoint, experience with SharePoint or other similar platforms
• Ability using a computer which includes expert keyboard and navigation skills and learning new programs.
• Communicate clearly and professionally with internal and external customers
• Work effectively individually and collaborate as part of a team to achieve established outcomes. Understand other’s roles and empower one another to take responsibility to be successful.
• Demonstrate collaborative interactions with peers to reach a common goal as well as be a resource to team members and internal/external customers
• Pay close attention to detail in all aspects of the job.
• Make decisions using available resources and sound judgment.
• Maintain confidentiality and discretion.
• Identify and resolve problems in a timely manner, gather and analyze information skillfully and…