Benefit Coordinator Resume Samples
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Benefit Coordinator Resume Samples
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AC
A Crona
Angus
Crona
221 Mohammad Forest
San Francisco
CA
+1 (555) 992 6428
221 Mohammad Forest
San Francisco
CA
Phone
p
+1 (555) 992 6428
Experience
Experience
New York, NY
Benefit Coordinator
New York, NY
Dach, Von and Klocko
New York, NY
Benefit Coordinator
- Performs other duties as assigned
- Responding to/resolving all associate inquiries and questions pertaining to benefits
- Participate in quality control measures for both current and future contract obligations with internal and external vendors
- Upload weekly benefit deduction files
- Process and audit monthly benefit billings
- Regularly audit benefit plans and deductions to ensure plan remain accurate and legally compliant
- Mediate effective resolution for complex payer/pharmacy issues toward a positive outcome to de-escalate
Philadelphia, PA
Benefit Coordinator
Philadelphia, PA
Davis and Sons
Philadelphia, PA
Benefit Coordinator
- Works either independently or as a member of the team on special projects to represent the Benefit function
- Work individually as well as being a team member
- Perform related duties such as preparing and presenting assigned reports, policy changes, and technical updates to staff frequently an effectively
- English sufficient to provide and receive instructions/directions
- Working with the human resources team, support company wellness initiatives
- Participate in continuous quality improvement initiatives and projects
- Develop spreadsheets, data bases and/or systems to track project programs
present
Detroit, MI
DME Benefit Coordinator
Detroit, MI
Cummings, Walker and Schroeder
present
Detroit, MI
DME Benefit Coordinator
present
- Assist in cross training opportunities for co-workers and new staff
- Work on revenue management projects
- Works closely with the Benefits team and employees to provide excellent customer service for all benefit related questions, issues and concerns
- Maintain vendor contact to investigate discrepancies and provide resolution
- Assists in the administrative functions of the benefit plan renewal process
- Assists in the maintenance of employee benefit records and prepares documentation necessary for implementing benefit coverage
- Review and may perform ,billing, claim generation collection and identification activities
Education
Education
Bachelor’s Degree in Business
Bachelor’s Degree in Business
Northeastern University
Bachelor’s Degree in Business
6 Benefit Coordinator resume templates
Read our complete resume writing guides
1
DME Benefit Coordinator Resume Examples & Samples
- Procurement of DME supplies and equipment. Negotiate and procure supplies and services through established Purchasing standards, contracts and sources. Review, validate and process all eligible physician/clinician referral requests; review referral for appropriateness and completeness, review health record to determine medical need and compliance to Medicare guidelines, contact vendor, coordinate delivery and pick-up of equipment with vendor/clinician/patient. Maintain compliance to regulatory standards for response times. Insure member eligibility for DME services: both benefit and current Medicare guidelines
- Manage costs through effective utilization review of rental equipment. Determine on-going need of rental equipment/supplies/oxygen based on clinical need, diagnosis and prognosis, regulatory guidelines. Work with appropriate clinician/physician to proactively recommend cost-effective changes in service delivery e.g. rental to purchase, discontinuation of service, step-down or product category, etc
- Ensure customer satisfaction by providing fast, reliable, courteous, auditable, appropriate service to our customers. Act as a liaison for DME services to all customers in the supply chain, both internal and external e.g. Care Coordinators, Discharge Planners, Home Health, Clinicians, Physical Therapy, Respiratory Therapy, Vendors, Claims, Purchasing/Contracting, Pharmacy, Members, etc. to ensure customer satisfaction. Problem-solve serve as resource; provide information on products, services, and processes
- Coordinate member face to face appointments and written orders prior to delivery to assure timely processing of physician request and extend the pending authorization period as necessary
- Research and resolve invoice and claims discrepancies. Reconcile differences in quantity, description, or pricing of equipment/products and services. Analyze and process DME claims for reimbursement received from members, various KP departments and other sources. Investigate reasons for these claims, determine appropriate reimbursement, and authorize payment
- Effectively communicate and develop and maintain positive relations interregional, interdepartmentally, and within the business community to insure professional and ethical business practices
- Provide ongoing system maintenance to the DME system to ensure the accuracy of the information. Research and discontinue recurring authorizations as appropriate. Identify and remove outstanding liabilities as appropriate. Ensure all authorizations have accurate HCPC codes and modifiers identified in the system. Perform other duties as requested
- Other duties as assigned to meet departmental and member needs
- Minimum three (3) years of health care experience with one (1) year of handling and/or processing DME referrals or claims
- Experience working with the elderly
- Associate's degree preferred
- Knowledge of the Kaiser Permanente systems and processes
- Knowledge of HMO environment
- HCPC coding
- Working knowledge of health plan benefits and policies
- IC-9/10 coding
- Excel proficient
2
Benefit Coordinator Resume Examples & Samples
- The Senior Coordinator, Individualized Care position is responsible for full benefit investigation including processing prior authorizations and working with physician offices to facilitate the appeal process. This position must ensure the insurance verification related to patient prescriptions are processed accurately, efficiently, and timely in complete accordance with all applicable laws, regulations and company policies. This position is responsible for guiding the patient through the various process steps of their patient journey to therapy
- Contact insurance companies as required to obtain and enter accurate benefit information to positively impact insurance processing and minimize rejections
- Mediate effective resolution for complex payer/pharmacy issues toward a positive outcome to de-escalate
- Experience conducting and documenting patient health insurance benefit investigations, prior authorizations, and appeals is a must (1-2 years)
- Knowledge of Medicare, Medicaid and Commercially insured payer common practices and policies is a must
- Critical and creative thinking is a must
- Knowledge of the Health Insurance Market Place and the Affordable Care Act preferred
- Knowledge of Medical/Pharmacy billing and coding is preferred
- Important to have a strong attention to detailSearch Jobs US
3
Benefit Coordinator Resume Examples & Samples
- Analyze data and resolve discrepancies internally for assigned projects/reports
- Review and may perform ,billing, claim generation collection and identification activities
- Respond to inquiries from EOHHS and other staff concerning assigned projects
- Work on revenue management projects
- Develop spreadsheets, data bases and/or systems to track project programs
- Perform related duties such as preparing and presenting assigned reports, policy changes, and technical updates to staff frequently an effectively
- Work individually as well as being a team member
- Research, gather and report upon statistical analysis and data
- Assist in cross training opportunities for co-workers and new staff
- Participate in quality control measures for both current and future contract obligations with internal and external vendors
- Participate in professional training as well as cross training activities to enhance performance and skill set
- Participate in continuous quality improvement initiatives and projects
- Foster compliance with state and federal regulations
- Preserve confidential, protected health and personally identifiable information and files
- Bachelor’s degree in Business/Health related discipline or equivalent experience
- 3 years experience in accounting, finance or public administration
- Knowledge of funding and revenue sources for health and human service programs
- Working knowledge of Microsoft Office including Word, Power point, Access and Excel Programs
- Ability to communicate effectively in both written and verbal formats
- Knowledge of the federal and Massachusetts state regulations associated with federal entitlement and commercial health insurance programs
- Extensive knowledge of MassHealth Eligibility and MassHealth Coverage
- Extensive knowledge of MassHealth’s eligibility systems
- Exceptional organizational skills
- Familiar with the ACA Healthcare changes and how it relates to Medicaid Programs
- Previous experience communicating professionally and effectively with public sector personnel, businesses, legal representatives, or private citizens
4
Benefit Coordinator Resume Examples & Samples
- Responding to/resolving all associate inquiries and questions pertaining to benefits
- Managing associate business files
- Upload weekly benefit deduction files
- Process and audit monthly benefit billings
- Regularly audit benefit plans and deductions to ensure plan remain accurate and legally compliant
- Working with the human resources team, support company wellness initiatives
- Key knowledge expert on company benefit programs to support associates
- Enter and process corporate, new hires, status changes and terminations
5
Benefit Coordinator Resume Examples & Samples
- Supports the Benefit Specialist with communication and interaction with the field HR team and HR Coordinators
- Assists with daily benefit processing, to include; enrollments, qualifying events, COBRA, beneficiaries, disability, accident and death claims, QMSCO, compliance testing
- Responsible for data entry, data tracking, and data information needs of the Employee Benefit functions, including oversight of qualifying events, verifying accuracy of data, and dependent verification functions
- Works closely with the Benefits team and employees to provide excellent customer service for all benefit related questions, issues and concerns
- Provide assistance with correcting Error Reports that are generated from electronic benefit files sent to carriers, to include; Medical, Dental, Vision, COBRA, FSA, 401K and Voluntary Benefits
- Assists in the maintenance of employee benefit records and prepares documentation necessary for implementing benefit coverage
- Maintain vendor contact to investigate discrepancies and provide resolution
- Routinely prepares HR reports related to Benefits
- Assists in the administrative functions of the benefit plan renewal process
- Works either independently or as a member of the team on special projects to represent the Benefit function
- Maintains confidentiality of all information
- Participates in and promotes a positive, supportive, cooperative team environment
- High School diploma or equivalent; prefer some college or technical school coursework, or equivalent benefit or HR work experience
- Excellent communication and organization skills are required
- HRIS systems experience
- Strong computer skills including Microsoft Office; Word, Excel, and PowerPoint
- Exercises sound judgment in responding to inquiries; understands when to route inquiries to next level
- Knowledge of all pertinent federal and state regulations affecting employee benefit programs, including ERISA, COBRA, FMLA, Section 125, ACA, Social Security and DOL requirements
- Must be able to speak to medium sized audience with and without the use of a microphone
6
Benefit Coordinator Resume Examples & Samples
- Supports the Call Center for HR Connect and Data Entry teams as needed internal and external
- Processes all written and verbal wage verifications and process payments and reconciliations
- Reconciles retiree , COBRA, and LOA payments
- Audits Comparison Reports internal and from vendors and resolves data issues and makes changes as needed
- Ensures new hires, rehires, terminations and disability certifications are efficiently and timely processed
- Processes all written and verbal wage verifications
- Maintains teammate files and follows procedures to ensure all legal requirements are met
- 2+ years of general Human Resource experience
- Strong organizational and administrative skills required
- Proficiency in Microsoft Office: Excel and Word
- Strong written and verbal communication skills & prior phone and customer service experience required
- Must be able to work independently and make sound business decisions
