Responsibilities*
Be an insurance liaison to receive and respond to escalated member issues
Identify and request the data needed to handle inquiries from internal departments and health plan vendors
Establish and maintain relationships with health plan vendors to expedite resolution of service issues and member complaints
Investigate claim and service issues as identified and communicate resolution to our members. Provide accurate servicing responses through telephone, and written correspondence
Implement and maintain database for tracking inquiries
Conduct root cause analysis to identify interventions to improve future outcomes or preventing ongoing issues related to insurance eligibility, benefit coverage details, and claims processes
Monitor trends and patterns of inquiries regarding health plans. Present detailed reports to Benefits Administration Office leadership, highlighting trends and proposing actionable solutions
Internal cross training to integrate Benefits Administration departments that may include: employee benefits eligibility and enrollment, employee shared responsibility, health care and dependent spending accounts, student benefit eligibility, Medicare enrollment, open enrollment education and other areas
Use varied methods (e.g. one-on-one, email, phone, webinars) to educate members on university benefits that may include medical, life, legal, vision, retirement, and disability
Develop member communications and ensure compliance with relevant state and federal regulations such as HIPAA, CMS, and ACA
Develop procedures and training materials, and educate Benefits Administration Office and internal departments staff members to provide administrative support on medical plans and eligibility
Required Qualifications*
Associates Degree or equivalent combination of education and experience
4 years' experience in a similar role requiring confidentiality, timeliness, customer service, organization, and prioritization.
Working knowledge of basic components of employee benefit plans and administration
Proficient in computer applications such as Google Suite, Microsoft, Power Point, and Excel