Quality Control Reviewer II

Quality Control Reviewer II

1199

SEIU Benefit and Pension Funds

Join to apply for the Quality Control Reviewer II role at 1199

SEIU Benefit and Pension Funds.

• 7387

• 1

• Full time

• Permanent

• Bargaining

• Hybrid

• 1199
  
  SEIU National Benefit Fund

• Non-Exempt

• Research and determine COBRA eligibility for members, spouses, and dependents of the 1199
  
  SEIU Benefit & Pension Funds.
• Review and process COBRA benefits via the eligibility and enrollment system (V3).
• Communicate with members and other professionals via telephone or written correspondence regarding COBRA eligibility and COBRA benefit related issues.
• Assist Member Service Front Window staff with COBRA member inquiries.
• Process COBRA election forms and create invoices based on eligibility and billing to members, including processing of refunds and adjustments.
• Import payments to COBRA payment application to update coverage.
• Create prescription (RX) record and maintain eligibility according to COBRA payments.
• Identify trends and work with various departments to troubleshoot issues.
• Perform additional duties and projects as assigned by management.
• Research member’s record and forward information to various internal/external areas for update of coverage and creation of COBRA application if required.
• Investigate and process COBRA adjustments and/or refunds based on eligibility review.

• High School Diploma or GED required; some College or Degree preferred.
• Minimum two (2) years’ experience in Eligibility, COBRA, or customer service required.
• Knowledge of COBRA laws and eligibility rules and regulations, benefit entitlement and plan rules for multiple funds (i.e., National Benefit Fund, Greater NY/NJ, Homecare and Home Health Aid).
• Basic skill level of Microsoft Word and Excel preferred.
• Able to work well under pressure, multi-task, establish priorities, meet deadlines, and follow through on assignments.
• Excellent customer service skills: ability to maintain professional manner and a pleasant attitude.
• Good interpersonal and communication skills; work well independently and as a team player.
• Good problem solver with excellent analytical and organizational skills.
• Must meet performance standards including attendance and punctuality.

• Entry level

• Full-time

• Administrative

• Hospitals and Health Care