• Job Description

  Req#: 11150

  Responsibilities

  • Perform eligibility and prescription benefit updates; accurately and professionally resolving issues in real time and providing excellent telephone customer service
  • Research, update, and follow up on changes such as: enrollment and workflows, eligibility and benefit elections in eligibility system (Vitech), PHI, prescription (Express Scripts), dental and call tracking (QNXT) systems.
  • Data enter enrollment information, relevant membership data, and supporting documentation obtained from various sources such as: Member Services, Outreach Department, satellite office - pension codes, employer reports, workers compensation, disability, home mortgage, Cross Fund reports, 1199SEIU Training and Employment Funds, GNY Spousal Premiums etc.
  • Communicate with management; keeping them abreast of any member issues that require escalation and report trends via established protocols.
  • Create various weekly and monthly Excel reports regarding productivity
  • Work closely with management in maintaining and reviewing work production
  • Provide clerical support to the Eligibility department including but not limited to: filing, photocopying, and faxing, etc.
  • Perform additional duties and projects as assigned by management

  Qualifications:

  • High School Diploma or GED required, some College or Degree preferred
  • Minimum two (2) years Eligibility systems knowledge/experience (Vitech, QNXT, or ESI) in a health benefits environment required
  • Minimum two (2) years customer service experience in a call center environment; or two (2) years’ experience in a member-facing position required
  • Comprehensive knowledge of enrollment documentation, eligibility requirements, benefit provisions and enrollment processing required
  • Excellent keyboarding skills required (minimum 6,000 KPH and 6% or less error rate)
  • Basic skill level in Microsoft Word and Excel preferred, able to perform enrollment data entry analysis and navigate eligibility systems (Vitech V3)
  • Excellent customer service and telephone skills a must; able to maintain pleasant and helpful demeanor ensuring professional services are provided
  • Ability to work well under pressure, multi-task, establish priorities, meet deadlines, problem solve and follow through on assignments
  • Good communication skills (oral and written) and ability to speak in a clear and concise manner
  • Available to work overtime preferred
  • Must meet performance standards including attendance and punctuality

• About the company

  Providing healthcare, pension, financial and social services, training, child care and more to 1199SEIU members. Contact us at (646) 473-9200.

Notice