Total Rewards Partner
Westchester Medical Center Health Network · Valhalla, NY · 2 days ago
Business DevelopmentFull-time
Responsibilities
- Maintains and processes benefit enrollments, changes and terminations for all plans, including medical, dental, prescription drugs, vision, flexible spending accounts, COBRA and retirement.
- Maintains and updates eligibility database and ensures proper enrollment of employees based upon eligibility guidelines, terminations and changes as required.
- Provides explanations of benefit programs to employees as well as departmental representatives to facilitate administration of these programs.
- Responds to employee complaints or problems and reviews and researches claim issues for participants.
- Gathers and compiles data and create reports as needed with HRIS database and Excel spreadsheets.
- Communicates with representatives from insurance companies to discuss benefits and claim issues.
- Audits and reconciles benefit plan invoices and eligibility files and processes monthly invoices for payment.
- Contacts, both in writing and by telephone, insurance carriers, employees and eligible former employees to ensure implementation of, and compliance with, program requirements as well as for resolution of unusual problems.
- Provides necessary data concerning enrollments, terminations, leaves without pay, and Medicare reimbursement claims as required.
- Analyzes and interprets new or revised requirements or programs for the purpose of determining their impact upon existing administrative and procedural activities.
- Aids in coordination of annual enrollment for plan participants ensuring all changes are processed correctly.
Qualifications/Requirements
- Experience: Five years of relevant experience performing employee benefits functions and assisting in the administration of health insurance plans, which included responsibility for identifying problems, obtaining and analyzing relevant information, and determining solutions.
- Education: High School diploma or equivalent, required. Associate’s degree, preferred.