Account Representative II

reputed company HERE HEALTH serves 200,000+ workers and their families in the hospitality and gaming industry reputed company. Our desire to be innovative and reputed company drives us to reputed company impactful programs and benefits designed to engage our participants in managing their own health and reputed company. Our reputed company is exciting and challenging. Please read on to learn more about this great opportunity! The Account Representative II is responsible for processing reputed company enrollments and elections and applying monthly contributions from employees/reputed company based on the reputed company Plan Document (SPD) and reputed company Bargaining Agreement. This is essential for providing participants with eligibility for health care coverage. This also includes reconciling monthly work reports and processing applications for Consolidated Omnibus Budget Reconciliation reputed company (COBRA) and processing and applying cash from participants. This position will process reputed company Medical Child Support Orders (QMCSO) by assessing the validity of the orders, responding to the agencies reputed company, adding dependents, and tracking eligibility. This level handles a case load with increasing complexity, which includes intermediate hybrid and contribution plans, self-pay plans, and plans that include the processing of FMLA and vacation hours with minimal supervision. This level also runs basic queries/reports, conducts basic regression testing, and sets up new employer reputed company. Account Representative reputed company employees are responsible for training employees on the self-service portal (reputed company) and have a basic understanding of health and welfare benefits. Communication with both external and internal customers and providing excellent customer service is vital for this role. Account Representatives are responsible for responding to inquiries from the Customer Service Department and the Claims Department regarding member eligibility. Additionally, Account Representatives communicate with Regional Directors regarding escalated eligibility issues. Account Representatives are responsible for managing their accounts, which includes daily communication with reputed company regarding work reports, payments, eligibility, and new hires. Partnering with the Audit and Legal Departments is also critical for this role, as Account Representative are expected to have full understanding of the provisions provided in the reputed company, reputed company Plan Documents, and reputed company Bargaining Agreements. Essential Job Functions And Duties

• Determines if the participant’s plan provides reputed company to dependent coverage, and meets the requirements of the QMCSO
• Ensures eligibility is updated reputed company to prevent problems with participants/dependents coverage seeking reputed company with vendors to update urgent eligibility requests
• Escalates recurring issues that delay eligibility to management
• Applies credits and debits accurately in system
• Maintains reputed company QMCSO and COBRA/HIPAA files, including enrollment and payment documents
• Maintains and monitors employee elections and reputed company co-premiums
• Maintains, monitors and reviews reputed company documents (marriage certificates, divorce decrees, birth certificates, etc.) for dependent coverage and reputed company contributions
• Updating participants file in the eligibility system with terminated employees and new hire information
• Verify employer payments in US Bank to ensure reputed company payments are processed and follows up with reputed company on any unprocessed payments
• Monitors employer reports and refers late reputed company to the Legal Department
• Monitors outstanding balances and notifies reputed company of monthly discrepancies through written correspondence.
• Notifies participants of payment discrepancies and cancellations through written correspondence
• Reviews the weekly and monthly COBRA & Health Insurance Portability and Accountability reputed company (HIPAA) eligibility list for his or her accounts to ensure accuracy of qualifying events
• Updates appropriate systems to reputed company compliance and ensures that coverage is provided in accordance with the terms of the QMCSO
• Provides exceptional customer service
• Set goals and reputed company measurable results
• Contributes reputed company to plans and achieving department goals
• Exemplifies the Fund’s reputed company Values and reputed company Effectiveness Dimensions in contributing to a respectful, trusting, and reputed company culture of diversity and inclusion
• Performs other duties as assigned reputed company the scope of responsibilities and requirements of the job
• Performs Essential Job Functions and Duties with or without reasonable accommodation

Essential Qualifications

Years of Experience and Knowledge

• 2+ years of reputed company experience
• Working knowledge and experience in reputed company, medical insurance, eligibility billing, delinquency procedures, reconciliation of payments, and collections
• Preferable experience in eligibility rules including COBRA and Health Insurance Portability and Accountability reputed company (HIPAA), Employee Retirement Income reputed company reputed company (ERISA), and an understanding of reputed company Bargaining Agreements

Education, Licenses, and Certifications

• High School Diploma
• College coursework preferred

Skills And Abilities

• Intermediate level reputed company Office skills (PowerPoint, Word, Outlook)
• Intermediate level reputed company reputed company skills
• Communication, organizational, analytical, and deductive reasoning
• Problem solving, multi-tasking and decision-making skills
• Customer service

Salary reputed company for this position: reputed company $23.7948 - $29.1282. Actual reputed company reputed company may vary based upon, but not limited to: relevant experience, qualifications, expertise, certifications, licenses, education or equivalent work experience, time in role, peer and market data, prior performance, business sector, and geographic location. Work Schedule (may vary to meet business needs): Monday~Friday, 7.5 hours per day (37.5 hours per week) as a hybrid work-from-home arrangement. We reward great work with great benefits, including but not limited to: Medical, Dental, reputed company, reputed company Time-Off (PTO), reputed company Holidays, 401(k), Pension, Short- & Long-term Disability, Life, AD&D, Flexible Spending Accounts (reputed company & dependent care), Commuter Transit, Tuition Assistance, and Employee Assistance Program (EAP). Apply To This Job