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Retiree Health Benefits (RHB) Coordinator

1199SEIU Family of Funds
New York, NY Full Time
POSTED ON 3/3/2025
AVAILABLE BEFORE 5/1/2025
Requisition #:
7156
# of openings:
1
Employment Type:
Full time
Position Status:
Permanent
Category:
Non-Bargaining
Workplace Arrangement:
Hybrid
Fund:
1199SEIU National Benefit Fund
Job Classification:
Non-Exempt

Responsibilities

    • Oversee and ensure the retirees are enrolled timely and accurately and the deliverables are completed timely to the Aetna MAPD plan
  • Understanding and resolving complex MAPD member inquiries while handling daily workflow processing
  • Establish Retiree Health Benefits for Medicare and Non-Medicare eligible retirees and their spouses
  • Resolve enrollment and eligibility issues for retirees and spouses as needed
  • Communicating and liaising with TPA vendors to review and resolve eligibility issues
  • Preparing daily/weekly Aetna MAPD operational files for submission to Aetna
  • Tracks and log monthly retiree inquiries, Aetna MAPD updates and prepare metrics report
  • Validate information on the Aetna MAPD exception reports and other retiree TPA exception reports
  • Process Qualifying Medical Support Court Orders
  • Perform the monthly Disability (DBL) report updates in the eligibility system
  • Assist with Social Security merges
  • Assist with QNXT inquiries and issues
  • Create and maintain current Standard Operating Procedures for daily processes.
  • Perform additional duties and projects as assigned by management
    • Establish and maintain effective working relationships with various departments
  • Perform additional duties and projects as assigned by management


Qualifications

  • High School Diploma or GED required, some College or Degree preferred
  • Minimum two (2) years Eligibility experience and one (1) year experience resolving eligibility matters and updating eligibility systems (Vitech,Medco) required
  • Intermediate skill level in Microsoft Excel, Outlook and Word required
  • Good knowledge of 1199SEIU eligibility benefits for all Funds (i.e., National Benefit Fund, Greater New York and Homecare)
  • Excellent customer service skills a must; able to maintain a pleasant and helpful demeanor
  • Excellent oral and written communication skills and ability to speak in a clear and concise manner
  • Ability to prioritize work with tight schedules and target dates
  • Demonstrated organizational skills with ability to multitask and follow up
  • Good problem solver with ability to work independently and as a team player
  • Must meet performance standards including attendance and punctuality

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