Benefits Plan Analyst
Point C is a National third-party administrator (TPA) with local market presence that delivers customized self-funded benefit programs. Our commitment and partnership means thinking beyond the typical solutions in the market – to do more for clients – and take them beyond the standard “Point A to Point B.” We have researched the most effective cost containment strategies and are driving down the cost of plans with innovative solutions such as, network and payment integrity, pharmacy benefits and care management. There are many companies with a mission. We are a mission with a company.
Point C is seeking a detail-oriented and analytical Benefits Plan Analyst to support our System Configuration and Plan Build Team. This role is responsible for reviewing, interpreting, and translating complex benefit plan documents into accurate, actionable materials for internal plan building and configuration teams. The ideal candidate will have experience working with self-funded healthcare plans and a deep understanding of benefit plan language.
Responsibilities:
- Analyze benefit plan documents to extract and translate benefit provisions into internal documentation used for plan builds.
- Create clear, comprehensive plan summaries and benefit mapping documents for new groups and renewals.
- Collaborate with internal teams (Plan Build, Implementation, Eligibility, Auditing) to gather requirements and clarify plan setup needs.
- Review and audit Summary of Benefits and Coverage (SBC) documents to ensure consistency with plan intent.
- Identify and resolve discrepancies or missing information in plan documentation, escalating issues as needed.
- Serve as a subject matter expert on plan language and documentation standards.
- Support continuous process improvement efforts related to benefit documentation and internal workflows.
Qualifications:
- Minimum of 2 years of experience in benefit plan analysis, medical claims, or related healthcare operations — preferably within a TPA or self-funded insurance environment.
- Strong ability to read and interpret complex benefit plan documents.
- Familiarity with benefit plan design concepts and terminology, including ICD-10, CPT coding, and healthcare regulations.
- Exceptional written communication and documentation skills.
- Detail-oriented with strong analytical and problem-solving capabilities.
- Comfortable working independently and cross-functionally in a remote, fast-paced environment.
Individual compensation will be commensurate with the candidate's experience and qualifications. Certain roles may be eligible for additional compensation, including bonuses, and merit increases. Additionally, certain roles have the opportunity to receive sales commissions that are based on the terms of the sales commission plan applicable to the role.
Pay Transparency
$65,000 - $70,000 USD
- Comprehensive medical, dental, vision, and life insurance coverage
- 401(k) retirement plan with employer match
- Health Savings Account (HSA) & Flexible Spending Accounts (FSAs)
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Paid time off (PTO) and disability leave
- Employee Assistance Program (EAP)
Equal Employment Opportunity: At Point C Health, we know we are better together. We value, respect, and protect the uniqueness each of us brings. Innovation flourishes by including all voices and makes our business—and our society—stronger. Point C Health is an equal opportunity employer and we are committed to providing equal opportunity in all of our employment practices, including selection, hiring, performance management, promotion, transfer, compensation, benefits, education, training, social, and recreational activities to all persons regardless of race, religious creed, color, national origin, ancestry, physical disability, mental disability, genetic information, pregnancy, marital status, sex, gender, gender identity, gender expression, age, sexual orientation, and military and veteran status, or any other protected status protected by local, state or federal law.
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