Health Eligibility Specialist North Atlantic States Carpenters Benefit Funds (NASCBF) Hamden, CT Job Details Full-time $45,000 - $50,000 a year 2 hours ago Benefits Health insurance Dental insurance Tuition reimbursement Paid time off Employee assistance program Vision insurance Life insurance Retirement plan Qualifications Computer operation Direct client contact Filing High school diploma or GED Records management Attention to detail Productivity software Full Job Description Company Overview The North Atlantic States Carpenters Benefit Funds (NASCBF) is responsible for the benefit plan operation for Massachusetts, Connecticut, Rhode Island, Maine, New Hampshire, Vermont, and New York State. We service approximately 24,000 active members of the North Atlantic States Regional Council of Carpenters and 22,000 retirees. The Funds are responsible for the operation of three retirement plans, a self-insured/self-administered health plan, and a vacation savings plan. Job Overview This position is responsible for all Health Fund processes relating to participants' benefits eligibility, updating participant & dependent files, and providing customer service to participants and or providers. This position is full-time, in office, 37.5 hours per week, Monday-Friday 8:30 a.m.- 4:30 p.m. Once eligible, an employee's benefits are fully provided by the employer. We are seeking a highly organized and detail-oriented individual to join our team. The ideal candidate will play a key role in maintaining accurate data, facilitating effective communication, and enhancing participants' understanding of their benefits. Responsibilities Provide superior customer service to participants (on the phone, in person and email) regarding Health Plan eligibility and benefits including all research and related follow-up work. Review enrollment documents such as Marriage/Birth Certificates, Divorce Documents, Adoption/Guardian Documents, Qualified Medical Child Support Orders, etc. Review and process eligibility documents such as Disability Extension applications, Military Extension documents, Widow Extension documents, Handicapped Dependent Application, Carpenter Training Center hours documents, etc. to determine eligibility and perform related participant system file maintenance. Develop understanding and competency of Health Fund rules and available benefits. Issue correspondence to members as needed. Correspond with all health plan network vendors including Medical, Prescription, Dental, Vision, and Hearing, regarding claims, eligibility, member/provider inquiries, utilization management, appeals, etc. Manage/Process/Perform maintenance of plan participant eligibility records within Fund's application and health plan vendor applications including activation and termination of participants. Process of COBRA, Self-Pay, and Short Hour Buy-Ins, including billing, collection, and processing of premium payments and related bank deposit preparation, reporting, participant system file maintenance and filing of related documentation. Process semi-annual Health Plan enrollment including: all system related processes, review of preliminary reporting and troubleshooting of all issues within participant records in the system. Ensure accurate document production and preparation for mailing of Health Eligibility Statements, COBRA and HIPAA Certificate document production and preparation for mailing, perform all related reporting, etc. Review, research, and process related correspondence to/from participants and providers as well as health plan network vendors. Perform Health Fund-related mailings. Assist in Front Desk coverage Perform other duties as assigned. EDUCATION and

EXPERIENCE

Post-secondary education (minimum Associate's degree or high school diploma and equivalent business experience). Experience in the field of health insurance benefits. Strong working knowledge of processing systems including Microsoft Office suite. Ability to work in a team environment and willingness to cross-train in all areas. Excellent interpersonal and communication skills. Must be able to interact effectively with internal staff and external clients.

PHYSICAL REQUIREMENTS

Answering the telephone and assisting members. Regularly required to operate standard office equipment (personal computer, photocopy machine, fax machine, etc.). Ability to work on a computer for up to 7 hours a day. Regularly required to sit for extended periods of time and occasionally stand and walk. Regularly required to use hands to operate computer and other office equipment. Close vision required for computer usage. Occasionally required to stoop, kneel, climb and lift up to 25 pounds. NASCBF is an Equal Employment Opportunity employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.

Pay:

$45,000.00 - $50,000.00 per year

Benefits:

Dental insurance Employee assistance program Health insurance Life insurance Paid time off Retirement plan Tuition reimbursement

Work Location:

In person