COBRA & Premium Billing Specialist
Title: COBRA & Premium Billing Specialist
Department: Group Insurance
Status: Full-Time, Non-Exempt
Under limited supervision, provide clients and participants with COBRA\Direct Billing services while remaining compliant with COBRA regulations. Collateral responsibilities may include training, new case implementation, and providing direction and assigning tasks to others as appropriate. This position will require interaction with clients and participants through phone call, emails, and fax communication regarding their accounts.
- Coordinates and administers assigned case load pursuant to service level agreements and compliance requirements
- Communicate with clients, brokers, insurance carriers, TPAs and other vendors via phone and email to resolve and troubleshoot participant issues and provide clarification
- Maintain, process and update participant’s accounts including benefit change and payment allocations within P&A’s software
- Ensure participant changes are processed timely and accurately with the insurance carriers/clients
- Process open enrollments, including updating rates, benefits, carrier information, invoicing participants
- Assist and support Customer Service Department and data team with plan questions and escalated issues
- Exercise independent judgement on a limited basis related to billing and eligibility taking into consideration P&A, carrier and client guidelines
- Keeps the Group Insurance Manager fully informed on all problems or unusual matters of significance and escalates when necessary
- Completes any additional assignments as requested by the executive/management team members
Education & Experience
- High School Diploma or Equivalent
- Knowledge of Federal and State COBRA laws and eligibility laws
- Knowledge of HIPAA with thorough understanding of HIPAA portability provisions and HIPAA privacy and security rules
- Thorough knowledge of all internal processes and software applications related to Group Insurance Department functions
- As competence and job knowledge grows, provide training, guidance and support to less senior colleagues
- Solid oral and written communication skills with ability to convey a message with diplomacy and tact
- Ability to effectively interact, present information, and respond to questions from customers, colleagues and management
- Ability to effectively manage multiple priorities utilizing effective organizational and time management practices
- Basic understanding of accounting principles related to AR/AP
- Strong Microsoft Office Skills - Excel and Word
With advance notice, occasional overnight and business day travel may be required for this role.
Fast paced work environment; flexibility to work schedules as required due to changing business demands. Occasional overtime is required. The work environment is moderately sedentary and typical of general office conditions with regard to standing, sitting, walking and lifting; no adverse conditions. An equal opportunity employer and a smoke, drug and alcohol-free workplace.
Completes any additional assignments and projects as requested by management.
This job description is designed to cover a general list of responsibilities and expectations for this role and does not contain a complete listing of activities, duties or responsibilities that are required for the role. Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time with or without advance notice.