Benefit Document Specialist I

Job Description

As a Benefit Document Specialist I , you will support the design and production of group benefit documents by interpreting group service agreements and renewal materials to ensure accurate and compliant benefit documentation. You will collaborate closely with Product, Sales, and Document teams to evaluate and fulfill requests for both new and renewing business. Through this work, you will develop in-depth knowledge of Wellmark’s benefit offerings and gain an understanding of how benefit design decisions impact upstream and downstream processes across the organization.

Ideal Candidate Summary

The ideal candidate is detail-driven, analytical, and experienced in health insurance benefits. They excel at interpreting complex group requirements, producing accurate and compliant benefit documents, and collaborating cross-functionally to support new and renewing business. Strong organizational skills, sound judgment, and the ability to manage deadlines in a regulatory environment are essential.

This role offers meaningful career growth, with the opportunity for promotion after one year based on demonstrated proficiency, quality performance, and advanced knowledge of Wellmark’s benefit structures and processes.

Qualifications

Required :

High School Diploma or GED.

• 2+ years of experience in the insurance industry with knowledge of benefits and terminology. Health Insurance industry experience is preferred with basic knowledge of health care delivery systems including applicable laws, benefit structures, and provider networks.
• Excellent verbal and written communication skills.
• Exposure to Microsoft Office applications and technical aptitude to learn new systems and tools.
• Ability to learn Wellmark’s contract benefits.
• Strong attention to detail with demonstrated ability to problem solve using guidelines to manage workload to meet timeframe goals.
• Strong organizational and time management skills.
• Ability to use deductive reasoning to probe, research, and seek to understand weighing alternative actions.
• Ability to measure and evaluate work processes, and utilize appropriate resources to identify next steps, potential impacts / risks, and solutions.
• Ability to make decisions that incorporate data, opinions, facts with tangible and / or intangible factors.
• Ability to work within a team environment and cross functionally within the organization to achieve department and corporate goals.

Additional Information

a. Support the design, production, automation and inquiries of benefit / group benefit documents including Coverage Manuals, Summary Plan Descriptions, SBC's, Financial Agreements and Stop Loss Policies within regulatory timelines.

b. Review and provide document design, creation and language expertise on client benefit selections by interpreting client requirements within their plan selections.

c. Research and prepare documents to encompass Federal and State laws and regulations.

d. Collaborate with Sales and various other Benefit and Document Specialists in interpreting, evaluating and accommodating accoun tmanager requests for new and renewing business.

e. Develop advanced knowledge of Wellmark Benefits and impact to upstream and downstream processes.

f. Identify and assist in implementing ongoing process improvements within the area or cross functional teams.

g. Other duties as assigned.