Retiree Health Benefits (RHB) Coordinator

Responsibilities

• Understand and resolve complex MAPD member inquiries while handling daily workflow processing
• Establish Retiree Health Benefits (RHB) for Medicare and Non-Medicare eligible retirees and their spouses
• Resolve enrollment and eligibility issues for retirees and spouses as needed
• Communicate and liaise with Third Party Advantage (TPA) vendors to review and resolve eligibility issues
• Preparing daily/weekly Aetna Medicare Advantage Prescription Drug (MAPD) operational files for submission to Aetna 
• Track and log monthly retiree inquiries, Aetna MAPD updates and prepare metrics report
• Validate information on the Aetna MAPD exception reports and other retiree TPA exception reports
• Process Qualifying Medical Support Court Orders
• Perform the monthly Disability (DBL) report updates in the eligibility system
• Assist with Social Security merges
• Assist with QNXT inquiries and issues
• Create and maintain current Standard Operating Procedures for daily processes
• Perform additional duties and projects as assigned by management

·        Establish and maintain effective working relationships with various departments

• Perform additional duties and projects as assigned by management

 

Qualifications

• High School Diploma or GED required, some College or Degree preferred
• Minimum two (2) years Eligibility experience and one (1) year experience resolving eligibility matters and updating eligibility systems (Vitech,Medco) required
• Intermediate skill level in Microsoft Excel, Outlook and Word required
• Strong knowledge of 1199SEIU eligibility benefits for all Funds (i.e., National Benefit Fund, Greater New York and Homecare)
• Excellent customer service skills a must; able to maintain a pleasant and helpful demeanor
• Excellent oral and written communication skills and ability to speak in a clear and concise manner
• Ability to prioritize work with tight schedules and target dates
• Demonstrated organizational skills with ability to multitask and follow up
• Good problem solver with ability to work independently and as a team player