Document Processor (Troy, MI)

Essential Duties And Responsibilities

• Understand the plan rules for eligibility as outlined in the Summary Plan Description (SPD)
• Process month end reporting
• Use reports to determine eligibility, reinstatement, or termination of coverage
• Prepare & mail enrollment packages and ID cards for newly eligible members
• Review calc reports and exception reports to update eligibility, as needed
• QA self-payment notices, COBRA notices, status slips, member/dependent letters to ensure accurate information and timely mailing to participants
• Process eligibility documents in OnBase for clients
• New member forms
• Vital information forms
• Medicare information forms
• Other insurance information forms
• Member/dependent PHI
• AH authorization
• Death notifications
• Qualified Medical Child Support Order (QMSCO)
• Eligibility appeals
• Loss of time credits
• Enrollment escalation requests (call center resolution form)
• Vendor file approvals
• Vendor discrepancy reports
• Evaluate legal documents such as divorce decrees, marriage certificates, birth certificates, etc. to determine dependent eligibility according to Plan rules
• Process payments for health & welfare coverage
• Request missing information from members
• Process eligibility escalations within 24 hours and call back members with updates, as needed
• Work with the pension department to ensure H&W deduction amounts are correct and properly set up for retired members and surviving spouses
• Understand Medicare rules and regulations to determine eligibility for Medicare benefits and update coordination of benefits in appropriate systems
• Verify and maintain employee demographic information, such as member or dependent address, contact numbers, birth date, social security number, or MBI number
• Comment system with appropriate updates based on documentation received
• Review and approve any plan changes, such as H&W rate changes, eligibility rule changes, or benefit changes with a vendor
• Meet daily/weekly quota requirements set by management team
• Update Redbook when necessary; within 24-48 hours of change notification
• Be knowledgeable of policies, procedures, and coverage of various funds

Qualifications

• Excellent Multi-tasking Skills Are a Must.
• Preferred Qualification - Spanish speaking.
• Education and/or Experience – High school diploma or GED and one year of eligibility experience.
• Language Skills – Must speak clearly and professionally.
• Mathematical Skills – General math skills.
• Reasoning Ability - Ability to apply common sense to carry out detailed written or verbal instructions.

Pay

The pay for this position is $23.00 an hour. Actual salary is dependent on skills, experience, education, and other business factors.