What are the responsibilities and job description for the Benefits Eligibility Assistant Manager position at Midwest Operating Engineers Fringe Benefit Fund?
Summary/Objective
This position is responsible for assisting the Benefits Eligibility Manager in providing daily support to the department to ensure adherence to established policies and procedures. Provide overall supervision of application processing, the initiation of eligibility determination, and enrollment relating to all MOE benefits for both the Active and Retiree Welfare Plans.
Essential Duties and Responsibilities:
- Assist the Benefits Eligibility Department with the appropriate responses to member inquires.
- Verify eligibility of members and determine member benefit coverage.
- Respond to inquiries received from members’, providers’, billing agencies, and health plans regarding status of claims, eligibility, authorizations, and available services/copayments.
- Ensures eligibility is accurate and up to date.
- Identify new opportunities to improve workflow processes ensuring the streamlining of eligibility.
- Process urgent updates through the system and update member records.
- Responsible for overall administration of COBRA benefits for assigned members.
- Follow up with carriers regarding urgent updates should the participant inquire on COBRA status once an update has been sent.
- Follow through on issues with other departments or outside agencies until resolved.
- Assist with training, interviewing, and hiring potential candidates.
- Develop and maintain team training, including training topics, agenda items and implementation.
- Provide assistance with preparing and tracking of appeals
- Implement team member reviews and able to provide feedback
- Review all letters for quality control and accuracy
- Perform other duties as may be assigned.
Education and Experience:
- A college degree preferred or equivalent business experience of two (2) years.
- 2 years of supervisory experience required.
- 3 years of customer service experience required.
Position Qualifications & Required Skills:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily:
- Must have appropriate phone / customer service etiquette.
- Proficient in Microsoft Office applications, knowledgeable in Salesforce and ISSI.
- Understand Coordination of Benefits including Medicare, also able to interpret custody agreements and order of payment.
- Highly developed sense of integrity and commitment to customer satisfaction.
- Ability to communicate clearly and professionally, both verbally and in writing.
- Able to handle complaints and unpleasant customers. Ability to resolve conflict.
- Has a pleasant, patient and friendly attitude.
- Strong decision making and analytical abilities.
- Possess a strong work ethic and team player mentality.
- The ability to work well under pressure (most of the paperwork is time sensitive).
- Ability to be detail orientated.