This position is responsible for performing all daily duties pertaining to new and existing groups and individual Plans.
- Answering inbound telephone calls from brokers/agents, existing clients, potential clients. Providing backup for provider and member calls.
- Process member additions, terminations or changes (Manually and Electronic Files)
- Provide eligibility information to the Plan Department and Provider Services (this may include calling or email group to confirm member’s eligibility).
- Run Monthly billing for all groups, once a month
- Account reconciliation (Retro-credits, new dues and disbursements).
- Mail monthly client invoices.
- Process daily bank deposit.
- Resolve account discrepancies by investigating documentation of previous payments and adjustments.
- Prepare Schedule A’s (Form 5500) for groups.
- Process check requests for plan refunds, capitation, commission or account discrepancies.
- Create new group profiles.
- Send Intent to Terminate letters to groups and members that are in jeopardy due to lack of payment and process accounts terminations.
- Send letters to over the age dependents regarding their coverage.
- Update Group’s monthly renewal information according to Rate Advisory Worksheet.
- Generate ID cards (csv file is generated for third party printing company once per week).
- EFT processing
- Monthly review of account receivable and financial books
- Review, track and administer major groups
- Interact with other departments (or areas) to resolve patient, group, broker or provider inquiries.
- Assist in training new staff in the Group Services Department.
- Process payments and refunds for Web Plan
- Filing and other clerical duties as assigned.
- Produce monthly renewal reports for Individual and Web Plan members
- Assist web plan members with renewing process.
- High School diploma and min. two years Customer Service or insurance industry experience
- Excellent oral and written communication skills
- Proficient in Microsoft Word and Excel
- General Math Skills
- Customer Service