Accident & Sickness Representative

About the role

The Accident & Sickness Representative provides customer service to participants, beneficiaries, union locals, regarding eligibility, benefits, and claims status. Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role.

Responsibilities

• Maintains current knowledge of assigned Plan(s) and effectively applies knowledge in all job functions.
• Provides verbal and/or in person customer service, responding to and documenting telephone and written inquiries in accordance with various Plan(s) benefits.
• Updates files, including documenting system notes of conversations or action taken.
• Performs tasks associated with the administration of health and welfare benefits such as sending required forms as requested by members.
• Initiates Action Requests to department requesting stop pay, return to work, address change as necessary.
• Follows up to ensure successful completion of Action Request.
• Researches and resolves complex calls.
• Performs other duties as assigned.

Requirements

• High school diploma or GED.
• Six months of experience working in customer service, third-party administrator processing, or benefits administration.
• Strong work ethic and team player mentality.
• Highly developed sense of integrity and commitment to customer satisfaction.
• Ability to communicate clearly and professionally, both verbally and in writing.
• Solid organization skills with strong detail orientation and listening skills.
• Ability to read, analyze, and interpret general business materials, technical procedures, benefit plans and regulations.
• Proficient computer skills including MS Office tools and applications.