What are the responsibilities and job description for the Benefits Representative position at California Winegrower Foundation dba Ag Health...?
Job Description Summary
The Benefits Representative (BR) is a key point of contact for health plan participants and insurance providers, offering essential support in benefits eligibility and inquiries. The BR plays a crucial role in ensuring a smooth and effective health benefits experience by confirming eligibility, resolving medical claims issues, and thoroughly documenting coverage-related interactions. Additionally, the BR supports employee education and open enrollment meetings.
Duties & Responsibilities
- Customer Service & Communication
A. Serve as the primary point of contact for participant and provider inquiries regarding health benefits.
B. Handle telephone and in-person interactions professionally, ensuring prompt and clear responses.
C. Prepare and distribute correspondence, maintaining detailed documentation of conversations regarding coverage and benefits.
D. Assist participants in understanding their benefits, claims processing, and eligibility requirements.
- Eligibility & Benefits Support
A. Utilize the health benefits system to verify eligibility and respond to inquiries from providers and participants.
B. Follow established protocols and reference plan documents to provide accurate benefit explanations.
C. Promote the use of in-network providers and cost-saving health plan features such as preventive care, telemedicine, urgent care, and health management services.
- Plan Administration & Documentation
A. Ensure proper distribution of benefit packets, including Identification Cards, provider listings, Summary Plan Descriptions (SPD), and Summary of Benefits and Coverage (SBC).
B. Assist in the preparation and presentation of annual open enrollment meetings, including bilingual benefit presentations.
C. Always maintain confidentiality and compliance with HIPAA regulations.
- Additional Responsibilities
A. Support team projects and initiatives as needed.
B. Work collaboratively with internal teams to improve processes and service delivery.
C. Perform other duties as assigned to contribute to the success of Ag Health Benefits Alliance.
Job Type: Full-time
Pay: $45,000.00 - $50,000.00 per year
Benefits:
- 401(k) matching
- Dental insurance
- Dependent care reimbursement
- Employee assistance program
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Schedule:
- 8 hour shift
- Monday to Friday
Application Question(s):
- What is your level of fluency in Spanish?
- Beginner
- Intermediate
- Advanced
Experience:
- Customer service: 3 years (Required)
Ability to Commute:
- Napa, CA 94558 (Required)
Work Location: In person
Salary : $45,000 - $50,000