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Health Benefits Officer II

AFSPA Washington, DC

  • Posted: over a month ago
  • Full-Time
Job Description
AFSPA

Description:

AFSPA is committed to hiring and retaining a diverse workforce. We are an Equal Opportunity and Affirmative Action Employer, making decisions without regard to race, color, religion, sex, sexual orientation, national origin, age, veteran status, disability, or any other protected class.


A Cover Letter and Resume are required for consideration. Resumes submissions without a cover letter included will be automatically disqualified from consideration.


Compensation for this position is in the $39k range to $44K range depending on qualifications and experience.


Summary: Handle incoming calls and correspondence from customers in a call center environment. Provide accurate detailed responses to their inquiries and move issues to a successful resolution based on the benefits outlined in the Plan's Brochure.


This position requires a minimum of 90% of work time to be on the phones.

Upon successful completion of training, contingent upon successful selection and hire, you may be assigned to our New Carrollton, Maryland Satellite Office or Washington, DC Headquarters location. Work location will be assigned based upon business need and at Management's discretion.


Duties and Responsibilities include the following:


1. Appropriately service customer regarding benefits, service and medical care issues. Provide timely and accurate information to incoming calls, emails and written correspondence from customers regarding claim status and health benefits. *

2. Ensure that complaints & appeals are processed in accordance with regulations, compliance standards, policies and procedures. *

3. Request customer address changes, claims inquiries and portal request according to established departmental policies and procedures. Work closely with business partners to resolve customer issues.

4. Identify and elevate appropriate issues to the supervisors/management staff

5. Route claims requiring an adjustment to the Plan's administrator and ensure all relevant information needed to reach a successful outcome is provided.

6. Completely and accurately, document all interactions necessary to handle customer issues in an accurate and timely manner. *

7. Follow up with customers as needed to update them on the progress of open issues and the resolution of closed issues in a timely manner. *

8. Return customer calls within 24 hours. *

9. Handle individual and other assigned Queues in Navigator and ASD.

10. Conduct yourself in an appropriate manner per the code of conduct in the employee handbook (section 4).

11. Other duties as assigned.

.Requirements:


Qualifications:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.


An individual must complete the AFSPA training program within 90 days of their hire, achieve at least a minimum passing score of 85% on ALL exams and maintain an acceptable level of quality.


Education/Experience:

High School Diploma or equivalent and a minimum of 1 year of customer service experience in an inbound/outbound call center environment; 1 year of health-related experience that requires attention to detail and problem-solving skills.


Work Location:

The following are work locations that AFSPA utilizes: New Carrollton, Maryland Satellite Office; Washington, DC Headquarters; and remote. Work location will be assigned and/or changed based upon business need and at Management's sole discretion.


Language Ability:

Ability to read and interpret general business periodicals, safety manual, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and business correspondence. Must possess excellent communication and written skills. Must have excellent organizational skills. Ability to speak effectively with colleagues and management.


Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public.


Math Ability:

Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals; and calculate figures and amounts such as percentages. Ability to draw and interpret bar graphs and pie charts.


Reasoning Ability:

Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram or schedule form.


Computer Skills:

To perform this job successfully, an individual should be strong in Microsoft Office Suite and research and literature review using the internet.


An individual should have knowledge Internet Explorer and database software.


Work Environment:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.


The noise level in the work environment is usually moderate.


Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.


While performing the duties of this job, the employee is regularly required to use hands and reach with hands and arms. The employee is frequently required to sit, talk, type, write, and hear. The employee is occasionally required to travel; stand; walk; climb or balance and stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 20 pounds. Specific vision abilities required by this job include close vision.



AFSPA

Address

Washington, DC
USA

Industry

Healthcare

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