Telephone Representative II; Retiree Services

Telephone Representative II (Retiree Services)

Join to apply for the Telephone Representative II (Retiree Services) role at 1199

SEIU Benefit and Pension Funds
.

Requisition #: , # of openings: 2,

Employment Type:

Full time
, Position Status:
Permanent
, Category:
Bargaining
, Workplace Arrangement:
Hybrid
, Fund:
1199

SEIU National Benefit Fund
, Job Classification:
Non-Exempt
.

• Maintain HIPAA compliance while communicating with 1199
  
  SEIU members and advocates via telephone or written correspondence regarding benefit eligibility and claim submissions; accurately and professionally respond to a high volume of calls and inquiries by providing excellent customer service.
• Respond to outbound inquiries which include voicemails and emails.
• Provide assistance with medical and pension benefits, Medical and Part B claims and retiree programs.
• Provide benefit eligibility requirements for Pension and Retiree Health Benefits to prospective pensioners and beneficiaries; research and establish eligibility for members and the reinstatement of terminated coverage.
• Generate inquiries for pension applications, pension estimates, check stop payments, death e‑forms and Medical Code updates.
• Update Member and/or Retiree demographic information (e.g., address, telephone number and email) as needed.
• Generate pension verification letters at member’s request and request duplicate 1099‑R Tax Forms as needed.
• Mail requested Pension and Retiree Health information such as applications, direct deposit forms, Preferred Drug Lists, Medical & Part B Claim forms, Enrollment Change forms, explanation of benefits, directories, etc.
• Communicate and explain Retiree Health Benefits (RHB) to retirees (i.e., Medicare Part D and 1199
  
  SEIU Medicare Advantage Plan); alert members of new RHB programs, plan improvements or changes.
• Research disability and medical claim history for claim status, accuracy, and timeliness; access various web‑based applications relevant to member’s inquiries.
• Communicate with Eligibility department via call tracking module (QNXT), e‑mail to update or terminate a member’s eligibility and Medicare Part D information.
• Generate inquiries for health cards; request letters of Creditable Coverage when necessary; contact Medicare and Centers for Medicare & Medicaid Services (CMS) to verify member Medicare Part D eligibility.
• Provide assistance to members of Aetna MAPD with eligibility and benefit issues.
• Perform additional duties and projects as assigned by management.

• High School Diploma or GED required, some College or Degree preferred.
• Minimum two (2) years high volume customer service experience in a call center environment; or two (2) years health claims processing experience; or two (2) years conducting pension calculations required.
• Knowledge of Pension and Retiree Health Benefits provided by the Funds preferred (National Benefit Fund, Greater NY and Home Care, Hospital League, 144 Hospital Pension, etc).
• Knowledge of web‑based applications, health claims systems, and call tracking systems with good navigation skills (Vitech and QNXT).
• Keyboarding skills required (minimum 5,000 KPH and 80% accurate rate).
• Excellent customer service skills required; able to maintain pleasant and helpful demeanor ensuring professional service is provided.
• Superb communication skills both verbal and written; able to communicate in a clear and concise manner and initiate own correspondence.
• Ability to work well under pressure due to the high volume and urgent nature of calls.
• Able to multi‑task, establish priorities, meet deadlines, and follow through on assignments.
• Member Services hours of operation are from 8:00 am – 6:00 pm; shifts are subject to change and/or availability.