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WM Michael Stemler, Incorporated

Billing & Eligibility Coordinator

Posted 9 Days Ago
Be an Early Applicant
Remote
Hiring Remotely in USA
22-22 Hourly
Entry level
Remote
Hiring Remotely in USA
22-22 Hourly
Entry level
Perform benefits billing and eligibility tasks: reconcile client eligibility and payments; process enrollments; enter and update employee/dependent records; order ID cards; handle vendor disbursements and reports; interpret COBRA and HIPAA; provide customer service to participants, clients, vendors and unions; maintain policies and meet department metrics.
The summary above was generated by AI

POSITION RESPONSIBILITIES

  • Review and reconcile client eligibility and payments.
  • Determines active, retiree, and COBRA eligibility based on plan sponsor plan provisions.
  • Processes enrollment eligibility files and completes enrollment edits in system queues.  
  • Enter new employees and dependents into the system and make changes to existing records as required.
  • Ensure identification cards are ordered correctly and timely according to plan sponsor and company guidelines.
  • Post & reconcile client payments.
  • Process vendor disbursements and reconciles payments according to vendor requirements and company guidelines.
  • Disburse end-of-the-month reports to clients as required.
  • Completes the review of and responds to vendor discrepancy reports as assigned.
  • Interprets and communicates COBRA and HIPAA regulations.
  • Handles self-pay administration according to plan provisions and guidelines.
  • Answers email and call inquiries from participants, clients, vendors and local unions.
  • Provides customer service and maintains effective relationships with clients, participants, agents, and brokers.
  • Update and maintain Client Policy and Procedure document.
  • Adheres to and is responsible for the understanding of company eligibility policies and procedures and resources.
  • Meets department production and quality metrics.
  • Participates in and contributes to mandatory department meetings, training, and company events.
  • Completes company, department, or plan sponsor special projects.
  • Follows company attendance policy and adheres to provisions in the collective bargaining agreement.
  • Upholds and exemplifies company values.
  • Performs other duties as assigned.
  • Review and process all internal and client specific weekly and/or monthly reports.
  • Email and Group folder organization.
Qualifications

This position is customer service oriented. It requires the ability to effectively communicate with HR staff at client groups, in addition to other external and internal customers; can prioritize assignments/tasks; work steadily, accurately and thoroughly; successfully meet assigned deadlines; evaluating and decision-making skills; reconciliation skills.

Education/Experience
  • Completion of High School or equivalent, including or supplemented by a course in bookkeeping, accounting or related. AA degree preferred.
  • Minimum 6 months in customer service with bookkeeping or accounting experience.
  • Can operate a 10-key adding machine.
  • Must possess good oral and written communication skills along with strong basic mathematical skills.
  • Proficient in Microsoft Applications and computer literacy.

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