Summary Responds to and resolves written, telephone and personal inquiries from subscribers, groups and providers concerning all FSA/HRA/HSA products, policies and procedures in a professional and efficient manner.
Coordinate and monitor daily administrative activities regarding FSA/HRA/HSA products to ensure established standards and deadlines are met.
Essential Responsibilities/Accountabilities: All levels Answers routine and complex questions, completely and accurately from subscribers, providers, groups, and other areas, either verbal or written.
Researches, interprets and responds to inquiries in a professional and efficient manner using problem solving skills.
Maintains membership files including adding, deleting and updating subscriber and group data.
Researches claims and determines claim eligibility in accordance with IRS regulations.
Performs on-line processing and adjudication of claims according to contract specifications/provisions and the company’ guidelines and policies as they pertain to the account.
Services customers, providers, and groups in a manner that ensures positive public relations.
Maintains current knowledge of department policies and procedures, IRS regulations governing flexible spending and parking reimbursement, COBRA rules and regulations and TPA policies and benefits.
Maintains current knowledge of TPA procedures and claim processing system.
Performs on-line processing and adjudication of claims according to contract provisions and TPA’s guidelines and policies.
Consistently demonstrates high standards of integrity by supporting the Lifetime Benefit Solution’s mission and values and adhering to the Corporate Code of Conduct, and Leading to the Lifetime Way values and beliefs.
Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures.
Regular and reliable attendance is expected and required.
Performs other functions as assigned by management.
Level I: Entry level
– requires little or no previous experience.
Duties performed under close supervision Plan assignments will consist primarily of simple FSA plans Attends all training required to become proficient in all aspects of the position Researches and resolves simple inquiries and adjustment transactions Level II In addition to Level I responsibilities: Duties performed under limited supervision Plan assignments will include less complex HRA plans Researches and resolves moderately complex inquiries and adjustment transactions.
Level III In addition to Level II responsibilities: Self-directed and dependable.
Able to perform complex research and resolution of inquiries and adjustments under very limited supervision Plan assignments will include more complex HRA plans and HSA plans Initiates involvement for higher level responsibilities or proactively volunteers for assisting in the resolution of escalated or systemic issues.
Serves as a resource to other associates Minimum Qualifications NOTE: We include multiple levels of classification differentiated by demonstrated knowledge, skills, and the ability to manage increasingly independent and/or complex assignments, broader responsibility, additional decision making, and in some cases, becoming a resource to others.
In addition to using this differentiated approach to place new hires, it also provides guideposts for employee development and promotional opportunities.
All Levels: Associate’s degree in Business Administration or related field with a minimum of one year of experience working in a benefit processing environment preferred.
In lieu of degree, a minimum of three years related work experience in a benefit processing environment.
Knowledge of rules and regulations for core operations.
Knowledge of hospitalization, medical/surgical, major medical, dental and Medicare benefits is desired.
Problem solving, reasoning and organizational skills.
PC experience including knowledge of Word and Excel.
Excellent oral and written communication skills.
Successfully pass a criminal record checkpoint and county criminal record background checks Level II In addition to All Level Qualifications: Associate’s degree in Business Administration and two years of experience.
In lieu of degree, a minimum of four years related work experience.
Strong proficiency in the use of Word and Excel Level III In addition to Level II responsibilities: Associate’s degree in Business Administration and six years of benefit processing experience.
Advanced knowledge of Word and Excel.
Experience with one or more FSA/HRA Administration software applications Expertise in all aspects of rules and regulations for core operations Physical Requirements The Lifetime Healthcare Companies aim to attract the best talent from diverse socioeconomic, cultural and experiential backgrounds, to diversify our workforce and best reflect the communities we serve.
Our mission is to foster an environment where diversity and inclusion are explicitly recognized as fundamental parts of our organizational culture.
We believe that diversity of thought and background drives innovation which enables us to provide leading-edge healthcare insurance and services.
With that mission in mind, we recruit the best candidates from all communities, to diversify and strengthen our workforce.
OUR COMPANY CULTURE: Employees are united by our Lifetime Way Values & Behaviors that include compassion, pride, excellence, innovation and having fun We aim to be an employer of choice by valuing workforce diversity, innovative thinking, employee development, and by offering competitive compensation and benefits.
In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position.
Equal Opportunity Employer 06022021