Claims & Eligibility Specialist (part-time)

The Accel Group is one of the largest independent and privately held insurance agencies in the Midwest, with over 120 employees across eight locations and four states. We have a strong history of over 90 years in business, and we pride ourselves on providing customized solutions to both individuals and businesses. Our dedicated team offers a professional approach and personal touch to meet each customer's unique needs. Products and services include Personal Insurance, Business Insurance, Claims & Risk Management, Employee Benefits, AgriBusiness Insurance, and Wealth Management Services.

Position Summary

Our RJ Lee office in Moline specializes in benefits consulting and administration in the Union/Taft-Hartley arena, and we are seeking a Claims & Eligibility Specialist to join our team. In general, this person will be responsible for providing customer service to members as it relates to their health insurance plans, assisting with the administration of those health plans, and handling associated claims for the health plans. Specific duties include, but are not limited to:

• Process weekly disability claims
• Answer member questions related to their eligibility, benefits, coverage, and/or claims
• Prepare and distribute health plan information to members
• Prepare and mail COBRA notices to members
• Act as a liaison between members and the pharmacy benefit manager as it relates to prescription claims
• Verify coverage and provide claim status updates to providers
• Record daily deposits and self-pays from members
• Transfer funds from accounts as necessary to pay claims and liabilities of funds
• Prepare and reconcile monthly reports for appropriate plans
• Prepare monthly, quarterly, and annual tax returns
• Reconcile monthly bank statements and Quick Book reports
• Prepare monthly annuity report and complete wire transfer each month
• Track monthly and quarterly invoices
• Prepare participation and retiree billing
• Prepare financial reports for quarterly trustee meetings
• Maintain proper documentation and accurate records related to the administration of the health plans and corresponding claims. This includes (but is not limited to) member eligibility and participation records, member communications, claim statuses and payments, billing, pension payroll files, etc.
• Assist with reception, telephone answering, and other office functions as needed
  
  

Minimum Qualifications

• High school diploma or equivalent.
• Previous customer service experience.
• Previous experience with medical insurance, benefit plan administration, medical claims processing, and/or third-party administration.
• Basic knowledge of medical insurance with the ability to answer plan and coverage questions.
• Additional experience with Taft-Hartley plans is helpful, but not required.
• Basic accounting experience is also helpful, but not required.
• Strong attention to detail and accuracy in work.
• Excellent customer service skills, including the ability to have positive customer interactions and maintain positive customer relationships.
• Excellent computer skills, including the ability to utilize Microsoft programs (Outlook, Word, and Excel), web-based computer applications, and other agency management systems.
• Excellent time management and organizational skills, including the ability to handle multiple projects or tasks, meet established deadlines, and change priorities as business needs require.
• Excellent communication and interpersonal skills, including both written and verbal communication.
• The ability to work collaboratively in a team environment, but also independently with minimal daily supervision.
• The ability to utilize basic office equipment, such as a computer, keyboard, mouse, monitors, printer, copier, and scanner.
  
  

Other Requirements

• All offers of employment are contingent upon the satisfactory completion of a pre-employment background check.
  
  

Work Schedule

• This is a part-time position consisting of three days per week. The ideal work schedule is 8:00 AM to 4:30 PM Tuesday through Thursday; however, there is some flexibility if needed. There is also the potential for this position to become full-time in the future.
  
  

The Pay Range For This Role Is

22 - 25 USD per hour(Moline)

PI259323245