Part-Time Benefits Services Associate

Objective:  Ensures a consistently superior level of client satisfaction. Maintains general billing and enrollment information for assigned client. Maintains client relationships. Evaluates Evidence of Insurability (EOI) for determination. Essential Job Functions: Maintains enrollment system for insurance programs including all paperwork , analyzing information, data entry and billings. Attends in person and virtual annual benefit fairs interacting with all level of employees and resolves all problems for both the employer and the employees. Actively engages employees to enroll at benefit fairs and as an enroller during Supplemental Life Open Enrollments. Promotes the supplemental program. Processes claims to carriers. Involves "cleaning the claim" when received from facility, determining payment history of facility, validating salary and eligibility, and benefit level. Resolves problem issues to expedite payment by carrier. Obtains all necessary documentation for claims and adheres to checklist. Maintains relationships with HR departments assisting in all insurance related aspects. Customizes forms for each facility to expedite the process for the clients. Generates EOI forms for individual subscribers, contacting employees directly to each the program administration at the facility level. Maintains the EOI database contacting facilities as approvals/declines are received. Claims Database – check on status of claims update/close contacting facilities as claims are pd/declined etc. Coordinates the "pass thru"/"jet approval" process for EOI forms for all facilities. Reviews, inputs, confirms data, maintains internal database, approves or sends forms to carrier for approval. Creates checklist. Correspond with the insured to answer outstanding questions and to inform them of the underwriting decision. Evaluates and audits data to assure that facilities are correctly calculating benefit levels and all program criteria are met. Interacts with claims processors regarding claim information. Answers inquiries regarding bills and enrollment status from plan participants. Abides by the terms and conditions of the Confidentiality & Non-Disclosure Agreement.   Non-Essential Job Functions: Responsible for maintenance of billing and mailing label information for each assigned client. Performs other duties as assigned.