Plan Setup Specialist

Job Summary:

Under general supervision, the Plan Coordinator I is responsible for creating, maintaining, and updating employer plans, insurance carrier records, and benefit configurations within company systems. This role focuses on accurate data entry, validation of plan information, and support of daily operational requests.

Responsibilities:

• Create and maintain employer plans and insurance carrier records.
• Enter and update plan setup information accurately and timely.
• Verify data against source documents and contractual information.
• Maintain organized and accurate plan records and documentation.
• Research basic benefit questions using payer websites and available resources.
• Verify patient eligibility, benefits, waiting periods, limitations, and frequencies as needed.
• Support dental offices with routine plan setup inquiries.
• Participate in benefit expiration reviews and plan maintenance activities.
• Meet established productivity and quality standards.
• Maintain compliance with departmental procedures and documentation standards.

Qualifications:

• High School Diploma or equivalent.
• 1-3 years of healthcare, insurance, dental, or data entry experience.
• Strong attention to detail and organizational skills.
• Microsoft Office proficiency.
• Typing speed of 50+ WPM preferred.
• Basic understanding of insurance terminology preferred.

Required Skills:

• Data Entry & Maintenance (Primary)
• Benefit Verification (Basic)
• Plan Design Knowledge (
• Claims Impact Analysis (Limited)
• Contract Interpretation (Basic)
• Problem Resolution (Routine)
• Process Improvement (Participate)