Assists employees, providers, and third-party administrators with eligibility and insurance claims filing processes; prepares and reconciles appropriate billing; strictly maintains multiple spreadsheet logs and records keeping systems; disseminates benefit eligibility and claims information to providers and employees; and assists in coordinating claims issues with the third-party administrator or insurance company.
Assists employees, providers, and third party administrator with eligibility and claims and/or loan filing processes. Verifies participation, eligibility, level, and type of benefit by telephone and/or written notice. Verifies and reconciles billing for self-administered and traditional benefit programs. Prepares reconciliation schedules reflecting adjusting/correcting entries for additions, deletions, type, eligibility, and services provided to insured. Prepares appropriate check request for payment obtaining authorized signature. Composes reports and correspondence. Maintains eligibility logs and files. Tracks participant eligibility and payments. Generates related reports. Conducts new employee orientation and/or open enrollment, enrolls eligible employees in respective benefit programs. Designs and conducts training on benefit related policies, processes, and regulations. Coordinates claim and/or loan filing process. Verifies eligibility and complies required paperwork. Submits completed documentation for appropriate signature. Maintains schedules and logs on various benefit programs. Reconciles payroll deduction with monthly billings. Prepares respective reports. Attends meetings.
Other duties may be assigned.
This job has no supervisory responsibilities.
Associate's degree from two-year college or technical school in Business Administration or related field; or three years related experience and/or training; or equivalent combination of education and experience. May include two years or more of undergraduate college course work.
An additional two years experience in a related business field is required. Prefer one year of experience in the insurance field.
CERTIFICATES, LICENSES, REGISTRATIONS
Must possess a valid driver's license with a driving history verified through a motor vehicle report that meets requirements for Cherokee Nation underwriting rating.
OTHER SKILLS AND ABILITIES
Computer literate. Must be knowledgeable with word processing, spreadsheets, and graphic software; routine office equipment; must have excellent written and verbal communication skills.