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We are seeking Actisure Policy Specialists to join our Enrollment/Fulfillment team! The role of the Actisure Policy Specialist is to configure the group and benefit information of the insurance plans sold and administered by Worldwide Insurance Services within the Actisure system. The configuration consists of utilizing several internal systems (Salesforce, IEA), the insurance certificate documents, and benefit interpretation forms to build each policy accurately for claim adjudication. The position will work collaboratively with other team members to manage daily production workload, assist in testing of new products, and troubleshoot issues as they arise with other internal business units.

Responsibilities:

• Evaluate new business, renewal business, and change requests that are submitted via Salesforce, to determine the proper policy configuration required within Actisure.
• Review the appropriate certificate and load the group demographics and benefit information to a Benefit Sheet template.
• Configure the Actisure system with the proper system settings, group information, and benefit details as indicated in the procedure document and benefit documents.
• Contribute to the auditing of other team member's policy setup.
• Properly document the policy completion, auditing, and various stages of the policy lifecycle within Salesforce or other means as needed (Excel).
• Assist in the testing of new products, product changes, or enhancements by building test policies in the test environments.
• Collaborate with other internal departments in the evaluation of the policy setup during regression testing.
• Collaborate with Management, Training and other Operational Departments for review, creation, and documentation of procedures relative to policy setup.
• Other duties as assigned.

• Minimum requirement of four-year college degree, preferable a BA/BS in Insurance Administration or Computer Science.
• Two to five years in an Operations function such as claims, audit, customer service, and account management. Experience in health insurance industry is desirable.
• Excellent verbal and written communication skills needed to effectively relate with internal departments and vendors any issues identified, or enhancements needed.
• Advanced proficiency with Medical/Dental benefit plans, certificate language review and interpretation.
• Intermediate proficiency in MS Office products (Excel, Word, and SharePoint).
• Proficiency with claims software, coding, and claims processing guidelines a plus. Familiarity with Actisure a plus.
• Strong analytical and organization skills demonstrated by the ability to meet deadlines and communicate risks to completion of assigned time frames
• Ability to manage multiple assignments simultaneously while maintaining quality standards and meeting assigned deadlines.
• Ability to make decisions and support them with documentation.
• Must speak and write fluent English.
• Employee is required to have at minimum an internet speed of 75 Mbps (standard high-speed internet access).

• Flexibility to work in an office and/or at-home, remote office environment.
• Overtime and/or schedule flexibility are occasionally necessary in this position. Individual may be required to attend key business/departmental meetings and/or perform certain business critical job functions outside of normal working hours.
• Physical Demands: Must be able to communicate internally and externally through receiving and responding to auditory and visual methods.