Key Family of Companies
Plan Builder
Key Benefit Administrators is currently seeking a Plan Builder to join the team. We are excited to speak to qualified candidates about this opportunity. This will be a remote position and includes a comprehensive benefit package and competitive salary! About Key Benefit Administrators We are on a mission to improve health and stabilize insurance costs for local communities. KBA was founded in 1979 as a privately owned full-service group benefit administration firm specializing in self-funded medical plans and is now one of the country's largest independently owned third party administrators. We pride ourselves on having supportive leadership, a family atmosphere, and a high performing culture - ask our employees - they have agreed that we are a Top Workplace since 2013. Position Summary: The Plan Builder is responsible for building and maintaining clients' benefit plans in the QicLink system to ensure accurate and automated claims adjudication. Plan builders act as QicLink "super users," supporting management and IT in optimizing system performance. Plan Builders will troubleshoot processing issues related to claims software and internal procedures, and test new software releases to ensure proper functionality. Additionally, they may be assigned special projects to address client-specific processing needs. Essential Duties and Responsibilities: Build and program groups and products in QicLink for accurate claims adjudication, using tools, checklists, and run-in plans as needed. Analyze plan documents and compliance materials to ensure correct system adjudication; recommend and implement QicLink adjustments. Manage benefit changes for renewals, amendments, and rewrites through plan freezing, building, testing, auditing, and updating notes before release. Maintain current records, detailed processing notes, and exception codes in both digital systems and plan files. Address claim inquiries, implement plan changes, escalate issues as necessary, and collaborate across departments to ensure timely processing. Train staff on new plans, attend meetings, coordinate with teams, and share QicLink insights to support consistency. Oversee special projects and provider arrangements, working with Provider Maintenance and IT to ensure proper automation and documentation. Does this sound like you? Four to six years of high-level claims processing and benefit knowledge. Medical terminology and coding. Two-three years of QicLink system and/or VBA software experience. One to two years of plan building experience. Reinsurance, specific and aggregate contract knowledge. General insurance knowledge and familiarity with federal laws affecting self-funding. Must be able to organize own work to control processes and meet deadlines. Excellent written and verbal communication skills especially in technical and report writing. Ability to work with other team members to control workload as well as work independently. If you are unable to complete an application for the Plan Builder position due to a disability, contact Human Resources by calling 800-560-3539 to ask for an accommodation or an alternative application process. All qualified applicants for the Plan Builder position will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender. DDNP02
Key Benefit Administrators is currently seeking a Plan Builder to join the team. We are excited to speak to qualified candidates about this opportunity. This will be a remote position and includes a comprehensive benefit package and competitive salary! About Key Benefit Administrators We are on a mission to improve health and stabilize insurance costs for local communities. KBA was founded in 1979 as a privately owned full-service group benefit administration firm specializing in self-funded medical plans and is now one of the country's largest independently owned third party administrators. We pride ourselves on having supportive leadership, a family atmosphere, and a high performing culture - ask our employees - they have agreed that we are a Top Workplace since 2013. Position Summary: The Plan Builder is responsible for building and maintaining clients' benefit plans in the QicLink system to ensure accurate and automated claims adjudication. Plan builders act as QicLink "super users," supporting management and IT in optimizing system performance. Plan Builders will troubleshoot processing issues related to claims software and internal procedures, and test new software releases to ensure proper functionality. Additionally, they may be assigned special projects to address client-specific processing needs. Essential Duties and Responsibilities: Build and program groups and products in QicLink for accurate claims adjudication, using tools, checklists, and run-in plans as needed. Analyze plan documents and compliance materials to ensure correct system adjudication; recommend and implement QicLink adjustments. Manage benefit changes for renewals, amendments, and rewrites through plan freezing, building, testing, auditing, and updating notes before release. Maintain current records, detailed processing notes, and exception codes in both digital systems and plan files. Address claim inquiries, implement plan changes, escalate issues as necessary, and collaborate across departments to ensure timely processing. Train staff on new plans, attend meetings, coordinate with teams, and share QicLink insights to support consistency. Oversee special projects and provider arrangements, working with Provider Maintenance and IT to ensure proper automation and documentation. Does this sound like you? Four to six years of high-level claims processing and benefit knowledge. Medical terminology and coding. Two-three years of QicLink system and/or VBA software experience. One to two years of plan building experience. Reinsurance, specific and aggregate contract knowledge. General insurance knowledge and familiarity with federal laws affecting self-funding. Must be able to organize own work to control processes and meet deadlines. Excellent written and verbal communication skills especially in technical and report writing. Ability to work with other team members to control workload as well as work independently. If you are unable to complete an application for the Plan Builder position due to a disability, contact Human Resources by calling 800-560-3539 to ask for an accommodation or an alternative application process. All qualified applicants for the Plan Builder position will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender. DDNP02