Benefits Specialist

Job Description

Job Description

Our client is seeking a dynamic and detail-oriented Benefits Associate to join our Health and Welfare Team. The individual must be capable of producing accurate work in a time-sensitive, deadline-oriented environment and have the ability to multitask while managing competing priorities. The role requires demonstrated proficiency with Microsoft Word, Excel, and Outlook, as well as experience using AS400 systems, an electronic calculator, and a postage machine. The candidate must be comfortable handling interpersonal situations and possess strong verbal and written communication skills to effectively manage customer service responsibilities.

Candidates must have insurance experience, particularly with claims, Medicare, and retiree benefits.

Provide plan participant and retiree support by responding to phone requests for medical, dental, and vision claim forms, address changes, and benefits-related communications. Verify phone inquiries concerning plan eligibility, coverage, and termination dates. Field benefits-related questions and assist with referrals to participating dentists.

Process applications for status changes such as correcting or adding family coverage, beneficiary changes, and changes from part-time to full-time status and vice versa, including mailing Horizon Blue Cross Blue Shield kits when necessary. Verify and mail medical and dental ID cards and update AS400 notes as appropriate. Request new medical, dental, and prescription ID cards to replace lost or stolen cards or cards with inaccurate information. Medical and dental ID card requests are mailed directly to vendors and prescription card requests are submitted to Fund management.

Support Summary Plan Description distributions and screen and refer difficult issues to management for resolution. Confirm plan participant and retiree medical, dental, and vision eligibility for providers and vendors and resolve provider or vendor eligibility problems by providing required eligibility documentation.

Update participant records in AS400 sessions and notes based on Fund-related transactions, primarily documenting the reason for the contact and the actions taken such as status changes or mailings. Verify employment status with the store or employer for participants reported as inactive and notify Fund management if the participant is disabled so that required system updates and vendor notifications can be completed.

Process plan participant applications involving missing information, adding or removing dependents, changing status from single to married and vice versa, and coordination of benefits with other insurance. Access the Vision Service Plan (Davis Vision) system to update participant information and vision coverage when needed.

Benefits: 100% paid family Benefits!
Dental insurance
Health insurance
Life insurance
Paid time off
Retirement plan
Vision insurance