What are the responsibilities and job description for the Administrative Services Specialist position at Consociate Health?
Job Description
Job Description
Consociate Health, a leading Third-Party Administrator, offers an opportunity to grow and develop your career in an environment that provides a fulfilling workplace for employees, and creates continuous learning and embraces the ideas and diversity of others.
As part of our Mission to make Healthcare more accessible and affordable for our clients through innovation solutions and expert consultation, we value the inherent qualities that are foremost in our Mission, Vision, Values- Compassion, Humility and Impact, which allow us all to create authentic relationships with our team and our clients.
Position Summary :
The Administrative Services Specialist reports to the Administrative Services Supervisor. This position maintains updated enrollment and benefit information for all self-insured employer groups.
PRINCIPAL DUTIES AND RESPONSIBILITIES :
- Answer inquiries from insured members, employers, vendors, etc., regarding eligibility, enrollment, COBRA issues.
- Process electronic eligibility matching for claims on a daily basis.
- Manage the process of benefit additions, changes and deletions in the benefit admin system within specified department standards.
- Oversee and process benefit additions, changes and deletions with miscellaneous vendors including, but not limited to Pharmacy Benefit Managers.
- Coordinate and process ID card requests for insured members.
- Assist with creation, setup and implementation of member ID cards for assigned clients.
- Performed detailed testing and quality checks on new or updated health plan file postings.
- Support the remediation of data issues found in testing and production through data analysis when appropriate.
- Perform regular quality control on worked files to proactively root out and troubleshoot issues and investigate root-cause of errors for process improvement.
- Provide COBRA administration for self-insured groups who request the service.
- Respond to HIPAA certificate requests.
- Run eligibility reports as needed.
- Participate in audits as needed.
- Notify management of overtime needs by completing appropriate forms.
- Perform other duties as assigned.
Benefits :
GENERAL EXPECTATIONS :
Provide and promote the delivery of services with a prevailing attitude of respect and recognition of the personal worth and dignity of every individual whether they are a customer or coworker.
Adheres to established safety standards and utilizes proper techniques to avoid work- related injuries.
Preserve the confidentiality of all business-sensitive information, including but not limited to that of insured groups and individuals, employees and applicants.
KNOWLEDGE, SKILLS AND ABILITY REQUIREMENTS :
PHYSICAL AND MENTAL ABILITIES :
Ability to utilize personal computer (manual dexterity is required to operate a keyboard), telephone system, and communicate with a variety of customers.
REPORTING STRUCTURE / SUPERVISION :
