Reimbursement Plan Admin I/II

About This Role

This Reimbursement Plan Administrator role involves responding to and resolving inquiries from subscribers, groups, and providers regarding departmental products and policies. It coordinates and monitors daily administrative activities to ensure established standards and deadlines are met, supporting customer service and claims processing for products like FSAs and HRAs.

Responsibilities

• Respond to all inquiries from internal and external stakeholders completely, accurately, and timely
• Research claims and determine claim eligibility in accordance with IRS regulations
• Perform online processing and adjudication of claims according to contract specifications
• Maintain membership data including enrolling, terminating, and updating participant and group data
• Administer group and member accounts in accordance with appropriate regulations and process all activity within service time standards
• Participate and attend ongoing training to further knowledge of regulations, software systems, policies and procedures
• Maintain knowledge of rules, regulations, policies, and benefits governing the department product portfolio
• Openly participate and collaborate with departmental and team members to execute on assigned tasks
• Consistently meet established departmental and team productivity metrics
• Assist in system and release testing and troubleshooting

Requirements

• High School diploma or equivalent
• Two or more years related experience
• Strong problem solving, reasoning, and organizational skills
• PC experience including knowledge of Microsoft Word and Excel
• Excellent oral and written communication skills
• Ability to manage multiple projects

Qualifications

• High School diploma or equivalent. Associate degree in business administration or related field preferred.
• 2+ years related experience for Level I, 4+ years benefit processing experience for Level II

Nice to Have

• Associate degree in business administration or related field
• Four or more years of benefit processing experience (for Level II)
• Strong proficiency in the use of Microsoft Word and Excel (for Level II)
• Advanced knowledge of Microsoft Word and Excel (for Level II)
• Experience with one or more of the product portfolio’s Administration software applications (for Level II)
• Expertise in all aspects of rules and regulations for core operations (for Level II)

Skills

* Required skills

Benefits