This position interfaces with department management, department staff and other Plans staff including the Audit, Contributions, Accounting, Benefits Analyst, Pension, Health Claims and Operations Departments. Phone contact with participants, participants representatives and production companies.

ESSENTIAL FUNCTIONS

Answer eligibility calls from participants and participants representatives.
Assist with open enrollment process.
Adjust participant records: add/delete, reinstate, terminate, and promote dependents.
Coordinate with providers to update participants and dependents coverage.
Process and set up coverage for retirees, and divorced and surviving spouses.
Set up COBRA and Self-pay coverage where applicable.
Monitor Delta Dental, ESI and Anthem Discrepancy reports through vendor 834 files and resolve issues.
Monitor and follow-up on Affidavit of Surviving Spouse, Dependent Confirmation Forms, disabled child verification, and Coordination of Benefits.
Assist any walk-in participants with any eligibility matters. Address questions regarding coverage and receive payments if necessary.
Compose correspondence in relation to eligibility issues and required documents such as second documentation for marriage, marriage, and death/birth certificates.
Prepare and reconcile Delta Care invoices to vendor for payment on a monthly basis.
Prepare and reconcile premiums for East Coast Assistant Directors Trainee premiums.
Process refunds due to overpayment or loss of coverage.
Prepare and reconcile with the Pension Dept. regarding retiree pension deduction list.
Create tailored letters regarding eligibility information as needed.
Review appeals due to late payment of premiums and late notice for adding dependents, and for change of coverage plan, COBRA qualifying events and election or notification expired for COBRA or during open enrollment.
Perform Retiree Drug Subsidy (RDS) reconciliation and compliance.
Handle reconciliation of Medicare Drug Subsidy program and CMS Section 111.
Coordinate with Address Change Dept. regarding participants missing addresses.
Assist department with various projects as necessary.
Regular, predictable, and reliable attendance in office is required.
Ability to accept direction and developmental guidance from supervisor.
Ability to work effectively with individuals at all levels.
Prepare daily correspondence/document for scanning.
Perform other duties as assigned.

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.

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