- Assist Welfare Benefit Manager with Add/Drop Report to ensure that member/dependent has dropped / reinstated. Mail out New Hire packages and re-hire notices. Reinstate members in all benefits databases.
- Processing medical claims reimbursements, as needed / required, as it was required this year by the D.O.L. to reimburse members ACA copay’s/co-insurances/denied claims.
- Processing: Hearing, Mental Health and Substance Abuse Claims, and any secondary insurance coordinated prescription claims. Contact members and providers verbally, by fax or in writing when necessary. Interact with vendors as needed (Horizon, Benecard, Davis Vision, Hear USA, Delta Dental) when necessary. Interact with Horizon Blue Cross Blue Shield and Managed Health Network Liaisons for Mental Health/Substance Abuse Lag Claims, in order to coordinate OON Deductible and INN OOP maximums per member/patient, in order to comply with ACA and Parity regulations.
- Disability Claims – Processing and maintaining member’s short term and long-term disabilities, periodically request medical documentation, track member’s eligibility and hours to ensure if member returned to work. Interact with Medical Consultant on approvals /documentations needed. Track member’s State Disability / Workers Comp Disability approvals. Run disability checks every Monday
- Update Age 19-26 Enrollments in Basys and all vendor databases and mail out Approval Letters for these dependents. Enter re-enrollment information on spreadsheet.
- Process Death Benefit notifications to beneficiaries, process death benefit claim and mail out death benefit payments.
- Assist Welfare Benefit Manager with Reciprocity Requests
senior benefits specialist
- Initial point of contact for all escalated policy and benefits-related inquiries for North America while simultaneously acting as a liaison point for offshore HR team in Manila
- Led biweekly benefits orientation webinars to provide education of benefits available to new hires and how to enroll in benefits through the benefits portal
- Facilitated one-on-one benefits orientations with executives to ensure a seamless onboarding experience
- Provided high quality customer service to employees to ensure time-sensitive benefits emergencies were handled professionally and resolved
- Fostered effective vendor relationships to ensure employee issues were handed off to the appropriate third-party contact and efficiently resolved
- Offered employees tutorials and guidance in navigating a newly implemented benefits portal
- Organized annual benefits vendor event at Sun Prairie campus for employees to interact with vendors and obtain in-person knowledge of current and upcoming benefits offerings
- Responsible for soliciting and analyzing carrier proposals.
- Preparing sales/renewal presentations for existing and prospective clients.
- Resolving day to day client issues/requests.
- Managed renewal calendars, ensuring appropriate timing for census requests, requests for proposals and final presentations.
- Provided educational support for clients in person and via webinar.
- Provide company employees with information regarding their health benefit options and assist them with enrolling into said benefits
- Provide assistance for employees with billing requests/inquiries as well as escalating cases to corporate benefits to resolve employee issues
- Advise employees on the potential to continue health coverage post-employment and provide appropriate coverage options
- Administered benefit plans in accordance with plan provisions, legal and regulatory requirements, and the reasonable service expectations of employee at all levels of the organization. Communicated benefit-plan specifications; worked with numerous carrier representatives to research claim issues.
- Serves as the main employee contact via phone, email and/or drop-ins to answer/resolve benefit questions and issues/problems; researches benefit plans/documentation; and assists employees with benefit plan enrollment and related paperwork
- Provides day-to-day administration of employee benefit programs
- Ran weekly audits and updates benefits status in various systems
- Develops positive working relationship with vendors, consultants and others to ensure timely delivery of services, accurate enrollment of employees and dependents, and compliance with plan documents and agreed-upon performance standards. Responds to requests for information from vendors, employees and regulatory bodies.
- Reconciles monthly invoices for Medical, Dental, Life, and LTD Plans, etc., and related issues.
- Submits bi-weekly retirement plan contributions to Fidelity and prepares the wire transfer for Accounting