-Communicate renewal and new benefit plans to internal staff-Assist in producing customized plan documents for HRA and FSA plans-Transfer member files received from insurance carriers via EDI transfers and manual data entry-Heavy contact with clients, brokers and members for all aspects of HRA and FSA plans; new business, renewals, enrollments, adjustments and billing-Complex billing (monthly, quarterly and annual) to clients and brokers using Excel spreadsheets and Access… Show more -Communicate renewal and new benefit plans to internal staff-Assist in producing customized plan documents for HRA and FSA plans-Transfer member files received from insurance carriers via EDI transfers and manual data entry-Heavy contact with clients, brokers and members for all aspects of HRA and FSA plans; new business, renewals, enrollments, adjustments and billing-Complex billing (monthly, quarterly and annual) to clients and brokers using Excel spreadsheets and Access database-Entering adjustments for transit plans-Build and maintain all new and existing group medical, HRA and dental benefit plans accurately to specific benefit percentages and limits on the CAPS2020 software systems-Set up and maintain CPT/ADA code validation-Set up and maintain mail routing of paper and EDI claims to individual analysts-Responsible for updating system to specific changes due to renewals and amendments-Communicate benefit plan designs and changes to the Claims and Customer Service staff Show less

-Responsible for the accuracy and staffing for all aspects of the claims processing and associated customer service-Organize and prioritize workflow, providing expertise to resolve unusual/complex issues-Establish processes for delivery of efficient service to plan sponsors and covered members-Mentor and train team members to enhance performance-Develop, write and deliver Annual Performance Reviews for reporting staff and provide performance counseling when necessary-Run… Show more -Responsible for the accuracy and staffing for all aspects of the claims processing and associated customer service-Organize and prioritize workflow, providing expertise to resolve unusual/complex issues-Establish processes for delivery of efficient service to plan sponsors and covered members-Mentor and train team members to enhance performance-Develop, write and deliver Annual Performance Reviews for reporting staff and provide performance counseling when necessary-Run, interpret and analyze team member productivity reports to identify success or deficiencies-Monitor workflow and shift responsibilities as needed-Identify any system problems that cause inaccurate claims payment or processing. Work with IT to resolve any system or benefit related issues-Build and maintain all new and existing group medical, HRA and dental benefit plans accurately to specific benefit percentages and limits on the CAPS2020 software systems-Set up and maintain CPT/ADA code validation-Set up and maintain mail routing of paper and EDI claims to individual analysts-Responsible for updating system to specific changes due to renewals and amendments-Communicate benefit plan designs and changes to the Claims and Customer Service staff Show less

-Set up and maintain new WebCOBRA software system with new client groups for COBRA and Retiree Billing administration-Continually monitor COBRA and State Continuation law, and communicate pertinent information to Clients, Brokers and staff-Follow all guidelines according to COBRA Law and ARRA for notifying participants of COBRA rights, coverage and premiums-Prepare customized monthly reports for Brokers and Clients on COBRA participation-Supervise and train COBRA Billing… Show more -Set up and maintain new WebCOBRA software system with new client groups for COBRA and Retiree Billing administration-Continually monitor COBRA and State Continuation law, and communicate pertinent information to Clients, Brokers and staff-Follow all guidelines according to COBRA Law and ARRA for notifying participants of COBRA rights, coverage and premiums-Prepare customized monthly reports for Brokers and Clients on COBRA participation-Supervise and train COBRA Billing Associates-Calculate and issue HIPAA certificates upon request-Heavy contact with clients, members and brokers for all aspects of the COBRA unit; sales, group installation, post payments, disburse premiums collected, monthly and quarterly billing, and renewal agreements-Oversee and prioritize workload for the COBRA\Retiree Billing unit-Establish processes for delivery of efficient service to plan sponsors and covered members-Mentor and train team members to enhance performance-Develop, write and deliver Annual Performance Reviews for reporting staff and provide performance counseling when necessary-Build and maintain all new and existing group medical, HRA, and dental benefit plans accurately to specific benefit percentages and limits on the CAPS2020 software systems-Identify any system problems that cause inaccurate claims payment or processing. Work with IT to resolve any system or benefit related issues-Set up and maintain CPT/ADA code validation-Set up and maintain mail routing of paper and EDI claims to individual analysts-Responsible for updating system to specific changes due to renewals and amendments-Communicate benefit plan designs and changes to the Claims and Customer Service staff Show less

-Build and maintain all new and existing group medical, HRA, and dental benefit plans accurately to specific benefit percentages and limits on the CAPS2020 software systems-Set up and maintain CPT/ADA code validation-Set up and maintain mail routing of paper and EDI claims to individual analysts-Responsible for updating system to specific changes due to renewals and amendments-Communicate benefit plan designs and changes to the Claims and Customer Service staff-Accurately… Show more -Build and maintain all new and existing group medical, HRA, and dental benefit plans accurately to specific benefit percentages and limits on the CAPS2020 software systems-Set up and maintain CPT/ADA code validation-Set up and maintain mail routing of paper and EDI claims to individual analysts-Responsible for updating system to specific changes due to renewals and amendments-Communicate benefit plan designs and changes to the Claims and Customer Service staff-Accurately process TRB claims; Medicare Part A & Part B, paper and EDI claims-Maintain and update the Provider files. Send letters, receive and file W9 forms-Provide customer service to TRB members and providers-Identify and resolve more complex issues that have been escalated-Meet with TRB members with benefit/claims questions-Attend TRB functions for the purpose of explaining TRB benefit plans to members and potential members Show less

-Accurately process all TRB claims; Medicare Part A & Part B, paper and EDI claims-Maintain and update the Provider files. Send letters, receive and file W9 forms-Provide customer service from TRB members and providers-Identify and resolve more complex issues that have been escalated-Meet with TRB members with benefit/claims questions-Attend TRB functions for the purpose of explaining TRB benefit plans to members and potential members