Compliance Specialist II

Company Overview
MedBen offers results-driven solutions through innovation in employee benefits and health plan management, fully supported by customized solutions and a dedicated team of people working for us. Our governing values include flexibility, respect, empathy, and dependability to meet our mission "To be the benefits partner that employers prefer.".

Job Summary
This position is responsible for supporting compliance-related responsibilities with respect to MedBen and its subsidiaries, as well as its self-funded clients. Duties include researching, summarizing, and explaining applicable federal and state law and regulation, assisting clients in meeting compliance requirements under state and federal mandates, drafting, and revising plan documents to client specifications, researching issues and memorializing findings, and researching, preparing, and filing regulatory forms and reports. Responsibilities also include specifically assigned department functions, including, but not limited to client communications.

Duties

• Assists in the research, review, analysis, and implementation of federal and state health care privacy legal and regulatory requirements pertinent to MedBen, its subsidiaries, and its clients, including clearly and effectively communicating regulatory changes and/or updates impacting MedBen, its subsidiaries, and its clients and educating MedBen employees and clients regarding such requirements
• Assists with creating and leading various types of compliance training and presentations
• Responds to subrogation matters and coordinates interrogatory responses and the production of documents, including assisting with responses to regulatory inquiries
• Prepares and manages regulatory filings including, but not limited to, surcharge, Medicare D testing, plan-related court orders, and mental health parity requirements
• Prepares and reviews plan documents, amendments, and other plan related documents in accordance with MedBen policies and procedures, applicable law and regulation and MedBen client specifications
• Assists in the creation and updating of contracts and contractual responsibilities for MedBen with clients and vendors, as assigned
• Creates and maintains work instructions for those duties assigned to this position
• Reviews, understands, and effectively communications current and proposed federal and state laws, rules and regulations pertaining to group health plans, including, but not limited to, ERISA, state group health plan law and regulation, self-funding of health benefits, pharmacy benefits, health care privacy, and mental health parity
• Research and monitors pending legislation at the federal level and in all states in which MedBen does business
• Maintains knowledge of applicable regulatory changes and court rulings which may impact existing policies and procedures pertaining to duties
• Evaluates relevant new laws, regulations, statutes, and rulings for applicability to MedBen’s insurance business and TPA (self-funded) operations and formulates plans for implementation, including suggested language changes to bring products into compliance with such laws, and notifying and training various affected internal and external parties, as needed
• Completes processes related to surcharge reports and regulatory filings, including review, analysis, application of information, and communication for applicable and pending laws and regulations
• Researches and monitors pending law and regulation regarding same. Keeps current on applicable legal and regulatory changes which may impact existing policies and procedures pertaining to these duties
• Provides assistance to other internal departments regarding the impact of related laws and regulations
• Supports MedBen internal and external customers by interfacing with other MedBen employees and departments, including, but not limited to, Customer Service and Account Management
• Performs Medicare D testing, noticing, filing and coordination of benefit responsibilities
• Reviews court documents pertaining to client plans to determine coordination of benefits
• Responds to inquiring attorneys regarding subrogation matters, including review of authorizations for the release of information and makes notification to subrogation vendor as applicable
• Performs any other duties assigned by the President, Vice President, Director, Manager or Supervisor of the Compliance Department, or as authorized by MedBen, as assigned

Preferred Knowledge, Skills, and Experience

• Minimum 4-year degree preferred or equivalent demonstrated experience in health benefit plan compliance or a comparable area with a health insurance company or health care third party administrator
• Proficient in Microsoft Office for Windows software, including Word and Excel
• Excellent verbal, writing, proofreading, and grammatical skills
• Analytical with effective research and information-gathering skills
• Proactive with the ability to work independently as well as collaboratively to support compliance objectives of the company and our client plans
• Organized with effective time-management skills
• Must be customer-oriented and able to adapt to MedBen’s corporate culture

Schedule

Individual team member schedules vary in order to cover department hours of 7am – 5pm Monday – Friday. Due to high volume business need, this department may have annual vacation blackout periods during January and/or February.

If you have any questions regarding a specific job position or completing the MedBen Employment Application, please contact MedBen Human Resources Manager Jill Evans at (740) 522-7382 or [email protected].

MedBen is an equal opportunity employer, and we consider applicants for all positions without regard to race, color, religion, gender, national origin, age, marital or veteran status, the presence of a non-job-related medical condition or disability, genetic information or any other legally protected status.

Benefits:

• 401(k)
• 401(k) matching
• Employee assistance program
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Referral program
• Tuition reimbursement
• Vision insurance

Application Question(s):

• I currently reside in central Ohio and can commute to Newark consistently

Work Location: In person