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Plan Configuration Specialist

About IBA

International Benefits Administrators (IBA) is a leading third-party administrator specializing in self-funded health plan administration. We partner with employers, brokers, providers, and healthcare stakeholders to deliver innovative benefit solutions, accurate claims administration, and exceptional service. Our organization is committed to operational excellence, technology-enabled solutions, continuous improvement, and a culture of accountability and collaboration.

About the Role

We are seeking a Plan Configuration Specialist to join our System Configuration team. As a third-party administrator for self-funded health plans, the Configuration team is responsible for translating benefit plan documents into accurate system configuration and adjudication logic. This role builds and maintains benefit plan configuration in Javelina and audits that configuration against source plan documents to ensure claims adjudicate correctly.

This is an individual contributor position. It is well suited to a configuration professional who takes ownership of benefit accuracy on their assigned plans and wants to grow their technical depth within a collaborative team.

Reporting Relationship

This position reports to the Manager of System Configuration and works closely with Claims Operations, Quality Assurance, Plan Document Services, Implementation, Enrollment, and Information Technology teams.

Work Arrangement

This is a hybrid position that combines onsite collaboration and remote work. The expected schedule and onsite requirements will be discussed during the interview process.

What You Will Do

• Analyze plan documents, Summary Plan Descriptions (SPDs), amendments, and SBCs to accurately configure benefit plans, accumulators, benefit categories, and adjudication logic in Javelina.

• Maintain configuration across assigned client plans as benefits change through renewals, amendments, and program updates.

• Self-audit completed builds against source plan documents and participate in peer review to validate accuracy and consistency before plans go live.

• Support new group implementations, renewals, and mid-year plan changes in partnership with Claims, Quality, Plan Documents, and Implementation teams.

• Research configuration-related claim defects and benefit issues, determine root cause, and apply corrections under established standards.

• Create and maintain build documentation, configuration notes, and audit records for assigned work, and follow team SOPs and configuration standards.

• Share knowledge of assigned plans and platform functionality with teammates, and assist with cross-training as needed.

• Identify inefficiencies and recurring issues in the build and audit process and raise recommendations to the Manager of System Configuration.

What You Bring (Required)

• 2+ years configuring benefit plans, accumulators, and adjudication logic on a TPA or payer administration platform (Javelina strongly preferred).

• 3+ years of experience in self-funded health plan administration as a configuration analyst, claims examiner, coder, or related role.

• Ability to interpret plan documents and translate benefit intent into system logic including deductibles, copays, coinsurance, out-of-pocket maximums, and plan limitations.

• Working knowledge of medical coding systems and their impact on benefit categories and claim adjudication.

• Strong Excel skills for reconciliation, reporting, audit support, and analysis.

• Exceptional attention to detail, sound judgment, and ability to manage multiple priorities independently.

Preferred Qualifications

• Experience with configuration audits, comparison tools, and quality control processes.

• Understanding of self-funded health plan operations including stop-loss/reinsurance interactions.

• Enrollment configuration experience.

• Experience cross-training or onboarding teammates.

• Experience with Javelina, Healthpac, or other claims adjudication systems.

What Success Looks Like

• Maintain high levels of plan configuration accuracy and quality on assigned plans.

• Reduce configuration-related claim defects through careful build practices and thorough self-audit.

• Contribute to standardization, documentation, and process improvement initiatives.

• Support successful implementations, renewals, and benefit changes delivered on schedule.

• Share knowledge that helps teammates build accurately and consistently.

Compensation and Benefits

Salary Range: $72,000 - $85,000 annually, depending on qualifications, experience, and overall fit for the role.

• Medical, Dental and Vision Insurance

• 401(k) Retirement Plan

• Paid Time Off and Company Holidays

• Professional Development Opportunities

• Hybrid Work Environment

Career Growth

Successful candidates may have opportunities to advance into senior configuration, lead analyst, supervisor, management, or other operational leadership positions as the organization continues to grow.

Core Competencies

• Accuracy First — Treats a correctly built plan as the product and identifies issues before claims are impacted.

• Systems Thinking — Understands how configuration decisions affect adjudication, accumulators, reporting, and member experience.

• Documentation Discipline — Documents work clearly and follows established processes rather than relying on tribal knowledge.

• Collaboration — Builds strong working relationships across Configuration, Claims, Quality, Plan Documents, and Implementation teams.

• Initiative — Identifies opportunities for improvement and brings them forward.

Why Join IBA?

If you enjoy solving complex benefit challenges, improving operational quality, and directly influencing how healthcare claims are administered and paid, IBA offers an opportunity to make a meaningful impact while working alongside experienced professionals in a collaborative environment.

Equal Employment Opportunity

International Benefits Administrators (IBA) is an Equal Opportunity Employer. Employment decisions are based on business needs, job requirements, and individual qualifications without regard to race, color, religion, creed, sex, pregnancy, childbirth or related medical conditions, sexual orientation, gender identity or expression, national origin, ancestry, age, disability, genetic information, marital status, veteran status, military status, or any other characteristic protected by applicable federal, state, or local law.

IBA is committed to fostering an inclusive workplace where all employees are treated with dignity and respect and are provided equal opportunities to succeed.

Essential Functions Disclaimer

The duties and responsibilities described in this job description are intended to describe the general nature and level of work performed by individuals assigned to this position. They are not intended to be an exhaustive list of all responsibilities, duties, or skills required. Management reserves the right to modify, assign, or remove duties and responsibilities as business needs dictate.

At-Will Employment (Recommended)

Employment Disclaimer

Nothing contained in this job description is intended to create a contract of employment, express or implied, or alter the at-will nature of employment. Employment with IBA is at will, meaning either the employee or the Company may terminate the employment relationship at any time, with or without cause or advance notice, subject to applicable law.