Contribution and Eligibility Analyst

Description

DEPARTMENT: Contribution and Eligibility

POSITION TYPE: Hourly, Non-Exempt

BARGAINING UNIT: OPEIU, Local 9 Bargaining Unit

SEIU Healthcare IL Benefit Funds is a dynamic benefits administration organization committed to providing the highest quality health and retirement benefits in the most financially responsible manner, while always acting in the best interest of the union members. The Fund serves over 20,000 union workers in the Nursing Home, Home Care, Childcare and Personal Assistant industries with the delivery of health and pension benefits.

Our 50+ employees epitomize the Fund’s core values of quality service, interdependence, effectiveness, and accountability, and forge an alliance with one another to carry out our shared mission and common agreements for those we serve.

The Contributions & Eligibility Analyst will assist the Contributions & Eligibility Manager with various types of analyses and projects that support enhanced functioning of the Contributions & Eligibility (C&E) Department, including eligibility/enrollment and contributions trends, compliance issues, and policy-related topics.

The Contributions & Eligibility Analyst is responsible for supporting the work of the C&E Department with oversight from the Contributions & Eligibility Manager.

This position’s tasks and responsibilities are dynamic and multifaceted. This position will need to effectively support the Contributions & Eligibility Department in accomplishing its objectives to collect all required contributions in accordance with participation guidelines and collection policies. Professional communication with both external and internal stakeholders and providing excellent customer service is vital for this role.

The Contribution and Eligibility Analyst will be responsible for the following:

• Read collective bargaining agreements and understand the basis upon which contributions should be made.
• Analyze eligibility reports and data to determine trends, create forecasts, explore anomalies, and troubleshoot data issues.
• Present data and create various reports, charts, and graphs that promote analysis, discussion, and identification of system improvements.
• Create and maintain standard and ad-hoc reports for internal trending and analysis.
• Serve as a back-up for the Finance Analyst as a C&E Technology Liaison for the benefits administration system, including organizing weekly meetings, maintaining the open items list, following up with vendor consultants on projects and scope of work orders, and raising C&E system concerns.
• Serve as back-up for the Eligibility Assistant as it relates to month-close processes, COBRA, and Smartsheet tickets.
• Process department related activity in the benefits administration system, including payments from employers, COBRA eligibility payments from members, and other eligibility maintenance functions.
• Respond to the Member Service Department for inquiries regarding pharmacy eligibility and special enrollments via the ticketing system and emails related to all eligibility matters.
• Process and distribute vendor eligibility files for claims, prescriptions and HMO vendors; ensure eligibility is accurate for special and retro-enrollments as identified by the Member Service Department.
• Provide recommendations for procedural changes that impact the Contributions & Eligibility Department and role in specific policies and procedures.
• Process and review checks received for all Funds within the organization, and on a regular basis, prepare the deposits for each Fund.
• Process and review ACH transactions received through the employer website or portal for upload to the bank by the Accounting Department.
• Generate and review monthly reports related to discrepancies and delinquencies to ensure collections of matters are being pursued accurately.
• Prepares inactive member files and other reports as needed in preparation for Board of Trustees meetings.
• Review and analyze various account receivable reports and generate reports detailing audit findings.
• Review and analyze contributions and enrollment trends.
• Complete member merge request.
• Serve as back-up for the Employer Relations Specialist as it relates to new facilities set-up.
• Collaborate with the other team members to scan, image, organize and maintain documents, adhering to the organization's document lifecycle procedures, and archive or destroy inactive records in accordance with the document retention policy.
• Assist in the formulation of internal controls and policies.
• Responsible for the creation and updates to the department manual by compiling, proofreading, and editing various departmental policies and procedures
• Create agendas using the Purpose, Outcome and Process (POP) Model, and thorough notes must be kept for each meeting.

This position requires the employee to handle Financial Information, Personal Identifiable Information (PII) and Protected Health Information (PHI) for our members and…