Plan Document Specialist
Full Time ₱25,000 - ₱30,000 / monthJob Overview
The Plan Document Specialist plays a key role in shaping and maintaining the foundation of our health plans. In this role, you’ll generate and update important plan documents, including Summary Plan Descriptions (SPDs), Certificates of Coverage (COC), Summaries of Benefits and Coverage (SBC), and related materials, ensuring they are accurate, compliant, and tailored to each client’s unique plan design. You’ll help translate complex legal and regulatory requirements into clear, well-structured documentation, while staying current with evolving healthcare laws and standards. This position is ideal for someone who enjoys detail-oriented work, regulatory alignment, and making a meaningful impact behind the scenes of healthcare benefits.
Key Responsibilities
- Draft, format, and revise Plan Documents and other required compliance materials.
- Customize templates to reflect client-specific plan designs, eligibility rules, benefits, exclusions, and funding arrangements.
- Ensure consistency between plan documents, contracts, and proposals.
- Maintain version control and assist with distribution of updated documents to clients and internal teams.
- Regulatory Compliance
- Monitor and interpret federal regulations (ERISA, ACA, HIPAA, COBRA, MHPAEA, etc.) that affect group health plans.
- Internal Staff Support
- Work with compliance, Implementation, and account managers to review and finalize documentation.
- Assist internal staff with understanding plan document terms, including clarifying provisions related to eligibility and coverage.
- Provide support during audits or legal reviews by supplying plan documentation and summaries as needed.
Tools and Systems
- Use document automation platforms or templates (e.g., Word-based macro templates or proprietary systems).
- Track document creation, review, approval, and delivery using workflow management systems.
Skills, Knowledge & Expertise
- 1+ year of experience in document drafting, compliance support, or a related administrative role; experience in U.S. health benefits or insurance is preferred.
- Experience managing and maintaining document templates
- Strong attention to detail, with the ability to identify potential red flags; awareness of regulatory requirements is a plus
- Proficiency in Microsoft Excel, including working with multiple sheets and using macros
- Experience creating and documenting SOPs for macros and processes
- Advanced skills in Microsoft Word, including template creation and formatting
- Experience producing final documents in PDF format, including creating forms using Adobe Acrobat
- Open to candidates without direct healthcare experience, provided they have strong legal or compliance writing backgrounds
- Comfortable with administrative, detail-oriented work; role is primarily focused on data entry
- Non-client facing role; no B2B interaction or calls required