Customer Service​/Eligibility Coordinator

Job Description

Job Overview

We are seeking a proactive and detail-oriented Customer Service/Eligibility Coordinator to join our team. In this vital role, you will be responsible for managing participant eligibility and processing medical claims. Your expertise will help streamline the claims process, provide excellent customer service support while enhancing participant satisfaction. If you thrive in a fast-paced environment and already possess or are able to learn on the job knowledge of claims processing software, this position offers an exciting opportunity to make a meaningful impact in our Funds' participants' lives.

Successful candidate will perform routine claims processing, process payments or rejections of benefits, answer incoming telephone calls and provide customer service to assist participants over the phone and in-person, calculate eligibility and coordination of benefits, monthly processing of self-payments, termination notices, COBRA notices, Qualified Medical Child Support Orders, and death benefit claims processing. Run reports, assist with mass mailings, request documents and other participant information as necessary, enter eligibility and dependent information in computer, and process voids, stop-payments, and refunds.

Performs other duties as needed.

Competitive Pay. Employer contributes to 401(k) with no employee match required. 100% employer paid Life, AD&D, STD and LTD benefits provided.

Qualifications:

1. Graduation from high school or equivalent combination of training and experience with emphasis on CRT entry or keypunch experience, work processing and/or mathematics preferred.

2. Six months proven interoffice experience.

3. Must be conscientious, efficient and dependable.

4. Willingness and ability to meet deadlines on a daily, weekly and monthly basis.

5. Office skills including: data entry and calculator.

6. Ability to use office equipment including PC and systems, including Microsoft Office (including Word and Excel), copy machine, and fax.

7. Ability to establish and maintain effective working relationships.

8. Physical ability to: a) sit for long periods of time, b) bend stoop and stretch as required to operate file cabinet drawers, c) carry files, books and other types of office paperwork and, d) operate PC keyboard and other office equipment.

9. Ability to be bonded.

10. Excellent customer service skills with the ability to communicate clearly verbally and in writing to others in English.

11. Ability to read and compose business letters and other documents in English.

12. Ability to learn claims processing software - ICD-9, ICD-10, and ICD coding standards

Equal Opportunity Employer

TIC provides consulting and administration of plan design, funding, eligibility testing, claim adjudication, benefit payment, FASB ASC 965 (formerly SOP 92-6), COBRA, HIPAA, SPD's, QMCSO's or QDRO's will welcome the comprehensive service solutions available at TIC Midwest, LLC.

TIC is an independent full service company that specializes in the administration and communication of employee benefit plans.

TIC has been in business since 1951. We have clients throughout the Midwest that are served from three TIC office locations. From the beginning, we have offered services to the multiemployer benefit plan industry. Many of the multiemployer plans operating today were designed and established by us. We are familiar with the special challenges of Taft-Hartley plans and the collective bargaining process.

We are proud of the long-term relationship we have with our clients. We are also proud of our staff which includes administrators, consultants, computer specialists, and accountants - many with advanced degrees and certifications.

TIC is a long-time member of the…