Overview
Quality Control Reviewer I Jobs in New York, NY at 1199SEIU Family of Funds
Requisition #:
7518
# of openings:
1
Employment Type:
Full time
Position Status:
Permanent
Category:
Bargaining
Workplace Arrangement:
Hybrid
Fund:
1199SEIU National Benefit Fund
Job Classification:
Non-Exempt
Responsibilities
- Analyze Coordination of Benefits (COB) information received from members and other insurance companies to establish primary and secondary eligibility for spouse and dependents
- Communicate via telephone with members, insurance carriers, and other professionals regarding COB inquires
- Respond to inquiries regarding COB from departments within the Fund (i.e. Provider Relations, Member Services)
- Prepare and mail letters to members and/or employers regarding the Coordination of Benefits
- Conduct investigation, when necessary, in determining (COB) eligibility
- Update COB patient maintenance screens and other applicable screens in the enrollment processing system Vitech (V3) for the National Benefit Fund, Greater and New York Benefit Fund
- Prepare weekly and monthly production reports via Microsoft Excel
- Perform additional duties and projects as assigned by management
Qualifications
- High School Diploma or GED required, some College or Degree preferred
- Minimum two (2) years relevant clerical experience in a general office environment required; high volume telephone customer service experience preferred
- Basic skill level in Microsoft Excel and Word preferred
- Knowledge of all Funds (NBF, GNY, GNJ) eligibility criteria
- Knowledge of eligibility systems and COB guidelines
- Excellent oral and written communication skills; ability to speak in a clear and concise manner
- Excellent customer service skills and ability to maintain a pleasant attitude; provide professional and courteous service to members
- Ability to prioritize work with tight schedules and target dates
- Problem solver with ability to work independently and as a team player
- Available to work overtime including Saturdays preferred
- Must meet performance standards including attendance and punctuality
Title: Quality Control Reviewer I
Company: 1199SEIU Family of Funds
Location: New York, NY
Category:
