Welfare Eligibility & Claims AssociateDEPARTMENT: Welfare REPORTS TO: Welfare Manager FLSA STATUS: Non-Exempt DIRECT REPORTS: None POSITION PURPOSE:The Eligibility & Claims Associate is responsible for verifying eligibility for the Funds' Welfare insurance programs and assisting approximately 20,000 Union members, 8,000 retirees and their dependents regarding their Welfare benefits coverage. Works in collaboration with the members and insurance vendors for any issues that may arise for both eligibility and claim inquiries. ESSENTIAL JOB FUNCTIONS:
- Requests missing information as necessary to complete enrollments.
- Determines coverage by examining Fund records.
- Reviews and processes retiree and member eligibility
- Updates and maintains member information in database.
- Assists members and retirees with eligibility and enrollment.
- Ensures proper enrollment with third party vendors.
- Tracks the eligibility dates of dependents.
- Maintains accurate records of all incoming claims inquiry.
- Communicates with vendors to ensure timely resolution of claims.
•Interacts, responds and resolves claim inquiries via multiple channels including phone, email and written correspondence. •Responsible for maintenance and review of Benefit Grids.
- Answer questions from Member Services, and/or Vendors regarding the eligibility and status of members in ULTRA.
- Identify and support implantation of process improvement and recommendations of enhancements to processes.
- Performs multiple work roles with expanded knowledge and skill sets such as data entry, processing multifaceted transaction, and handling eligibility inquiries under minimal supervision.
- Performs other duties as assigned or required.
EDUCATION & EXPERIENCE:•Associate degree.•Experience in health and welfare benefit plan administration preferably in a multi-employer environment.•Experience with electronic data interchange systems.•Experience in claims operations including claims data analyzation, eligibility, and auditing activities.REQUIRED SKILLS/ABILITIES:•Excellent verbal and written communication skills •Superior organization skills •Requires independent decision making in complex situations.•Demonstrated ability to effectively manage multiple priorities. •High attention to detail.•Excellent problem solving and analytical skills required.•Knowledge of ISSI systems or knowledge of benefit administration systems and strong ability to learn new systems.•Proficient in MS EXCELApply:To apply, please send resume to ...@nyccbf.org EEO StatementThe NYCDCC Benefit Funds are committed to a policy of Equal Employment Opportunity and will not discriminate against an applicant or employee on the basis of race, creed, religion, color, national origin, ancestry, alienage, pregnancy, disability, age, uniform service member status, veteran status, marital status, caregiver status, familial status, status as a victim of domestic violence, sexual violence or stalking, membership in a domestic partnership, sex, gender (including gender identity, gender expression or status as a transgender person), genetic information, sexual orientation (including an individual's actual or perceived romantic, physical or sexual attraction to other persons, or lack thereof, on the basis of gender), sexual and reproductive health decisions, or on any other characteristic protected by applicable federal, state, or local law.If a reasonable accommodation is needed to participate in the job application or interview process, please contact Luan Delpeche at (212) ###-####. Salary and Benefits:Salary Range: $50,000 to $57,000 The rate of pay offered will be dependent upon candidates' relevant skills, education, and experience. The NYCDCC Benefit Funds offer a generous and competitive benefit package. Salary Description $50,000-$57,000