Date Posted: April 22, 2019
Job Type: Direct Hire
Job ID: 353098
Employee Benefits Claims Service Rep.
A. JOB DEFINITION
Assists members with ancillary coverage group medical and claim and coverage questions and concerns.
B. ESSENTIAL DUTIES AND RESPONSIBILITIES
Assist members with that can include coverage issues and member level billing in relation to the claim
- Explain client member Explanation of Benefits notices
- Explain coverage details for client members
- Assist employers with their billing issues
- Work with carriers, providers client management and members
- Communicates with Employee Benefits Account Executives and Account Managers
- Performs other duties as required
C. QUALIFICATION REQUIREMENTS
Must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
1. EDUCATION and/or EXPERIENCE
Any combination of education and experience equivalent to an Associate of Arts degree (AA) or equivalent from a two?year college or technical school and three (3) plus years of experience with group medical and ancillary coverages, claims and employee benefit member services.
2. REASONING ABILITY
Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists; and interpret a variety of instructions furnished in written, oral, diagram or schedule form.
3. LICENSES, CERTIFICATES, ETC.:
Requires possession of the appropriate insurance license as issued by the California Department of Insurance.