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Eligibility and COBRA Coordinator
Seeking individuals who share our passion for attaining quality affordable health care.
Manitowoc, WI / Plymouth, WI / Sheboygan, WI
Job Description
Position location – Sheboygan, WI Office. Options will be considered regarding a flexible work arrangement after the full training has been successfully completed.
JOB
Manage confidential and sensitive medical, dental, vision, Flex, Short Term Disability and personal information for members and dependents. Perform and maintain data entry via imported eligibility files, Web Eci, and manual enrollments on a timely basis using the Eldorado System and COBRA system for eligibility and COBRA. Work with Claims Adjudicators, Account Managers, and HR representatives on a daily basis to maintain member and dependent information.
SUMMARY OF ESSENTIAL
Setup, maintain, and manage eligibility data, demographics, and coverage for new groups, members, and dependents in all systems. Answer members’ and human resource department’s questions, concerns, and issues regarding eligibility. Meet with members’ and human resource representatives as needed.
Setup, generate, and maintain COBRA documentation, Certificates of Creditable Coverage, payments, and spreadsheets. Continually maintain and update COBRA records and files accordingly in all systems. Provide well-informed and educated answers to members’ and human resource department’s questions, concerns, and issues regarding COBRA.
Setup, maintain, and manage spousal and dependent forms and send out second and final notices as necessary. Work with appropriate Human Resource Representatives concerning age limits and terminations of all dependents ceasing to be eligible for coverage. Notify appropriate contacts of changing eligibility information.
Resolve and manage prescription questions, concerns, and issues in a timely manner by contacting PBM contacts/ HR representatives and members as needed
Setup, maintain, and manage all medical and dental identification cards. Work with vendor to print cards in an accurate and timely manner on a weekly basis.
Assemble COBRA payments by group/company on a monthly basis. Complete COBRA Payment Listing reports for each COBRA group; make copies and forward to the finance department for appropriate allocation.
Assemble Census and Adjustment Reports as requested, or assist the group with the web portal.
Provide assistance to company operators on an as-needed basis in a courteous and professional manner.
Attend seminars, conferences, meetings, webinars, etc. to remain well-informed and current of any changes in third party administration, eligibility, and system operations.
POSITION REQUIREMENTS
Education and/or Experience
High school diploma or general education degree (GED), and two years minimum of related work experience and/or training, or equivalent combination of education and experience.
Previous administrative experience medical benefit plans and a working knowledge with COBRA regulations is highly preferred.
Prairie States Enterprises, Inc. is a third party administrator, a benefits industry leader, and a trusted advisor to self-insured companies and their employees. We stand apart as a team of passionate people driven by a quest for excellence, who strive to improve the health status and benefit plan experience of our client companies, their employees and families across the nation.
Just as we are committed to improving the lives of our members, we are equally committed to cultivating the careers of forward-thinking professionals. Our corporate culture is one of ambition, integrity, empowerment, teamwork and a passion for personal and company success.
To the selected candidate, we offer:
- Competitive compensation (base + incentive) tied to experience and also a comprehensive benefit package provided to include Medical, Dental, Vision, Life, STD/LTD, FSA, Paid Time Off, personal days, 401k with match, wellness and exercise membership and more. Click HERE to view our full-time benefits flyer.
- Opportunity for meaningful career growth within a results-driven company and our company culture is one of ambition, integrity, empowerment, teamwork and a passion for personal and company success.
Job Summary
Company
Start Date
Immediate
Employment Term and Type
Regular, Full Time
Hours per Week
40
Work Hours (i.e. shift)
8:30am-4:30pm
Required Education
High School or Equivalent
Required Experience
2 years
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