Customer Service/Eligibility Coordinator

TIC Midwest, LLC; Michigan; On-site; USD 34,000 - 52,000; Full time

Benefits offered by this job

401(k) matching not required

Job summary

TIC Midwest, LLC is seeking a proactive Customer Service/Eligibility Coordinator to manage participant eligibility and process medical claims. You will assist participants by phone and in person, learn claims processing software, and ensure timely processing of payments and refunds.

This role supports the Funds' participants and aims to streamline the claims process. The position emphasizes customer service, accuracy, and deadlines, with employer-paid benefits including life, AD&D, STD, and LTD.

Qualifications

• Graduation from high school or equivalent with emphasis on data entry and math preferred.
• Six months proven interoffice experience.
• Conscientious, efficient and dependable.
• Meet deadlines daily, weekly and monthly.
• Proficient in data entry, calculator and office tasks.
• Ability to use PC and Microsoft Office (Word/Excel) and other office equipment.
• Able to establish and maintain effective working relationships.
• Physical ability to sit long periods and lift as needed.
• Bondability and clear English communication skills.
• Read and compose business letters in English; learn claims processing software (ICD-9/10).
• Equal Opportunity Employer.

Responsibilities

• Perform routine claims processing and processing payments or rejections.
• Answer incoming calls and provide customer service to participants.
• Calculate eligibility and coordination of benefits.
• Process monthly self-payments, termination notices and COBRA notices.
• Handle Qualified Medical Child Support Orders and death benefit claims processing.
• Run reports, request documents, enter eligibility data, and process refunds.

Skills

Customer service

Data entry

Microsoft Office

English communication

Time management

Learn claims software

Education

High school diploma

Tools

Claims software

Job description

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

Company Description

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 International Foundation of Employee Benefit Plans and the Society of Professional Benefit Administrators. Our employees have, over the years, been directors and committee members of these organizations and have been speakers and authors for them on a wide range of employee benefit topics at educational seminars and programs they conduct around the country.

Equal Employment Opportunity (EEO) Employer

Company Description

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