Health Benefits Officer II

at  American Foreign Service Protective Association

A RESUME IS REQUIRED FOR CONSIDERATION. APPLICATION SUBMISSIONS WITHOUT A RESUME INCLUDED WILL BE AUTOMATICALLY DISQUALIFIED FROM CONSIDERATION.

Compensation for this position is in the $43k range to $48k range, depending on qualifications and experience.

QUALIFICATIONS:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The HBO II position is an inbound call center, and it entails a 90-day training that includes tests throughout the training period. You are required to have a minimum of 85% or above passing score on all tests.

There are 3 phases of training:

• Brochure - Open book assessment
• Systems – Various databases
• Phones – Taking live calls

EDUCATION/EXPERIENCE :

High School Diploma or equivalent and a minimum of 3 years of customer service experience; Attention to detail and problem-solving skills.

• Appropriately service customer regarding benefits, service, and medical care issues. Provide timely and accurate information to incoming calls, emails, and written correspondence from customers regarding claim status and health benefits*
• Ensure that complaints & appeals are processed in accordance with regulations, compliance standards, policies, and procedures. *
• Request customer address changes, claims inquiries and portal request according to established departmental policies and procedures. Work closely with business partners to resolve customer issues
• Identify and elevate appropriate issues to the supervisors/management staff
• Route claims requiring an adjustment to the Plan’s administrator and ensure all relevant information needed to reach a successful outcome is provided.
• Completely and accurately, document all interactions necessary to handle customer issues in an accurate and timely manner.
• Follow up with customers as needed to update them on the progress of open issues and the resolution of closed issues in a timely manner
• Return customer calls within 48 hours. *
• Handle individual and other assigned Queues in Navigator and ASD
• Conduct yourself in an appropriate manner per the code of conduct in the employee handbook (section 4).
• Other duties as assigne