Benefit Coordinator Job Description
Benefit coordinator
provides authorizations and coordinate services for the New York State Medicaid managed long-term plan health plan members.
Benefit Coordinator Duties & Responsibilities
To write an effective benefit coordinator job description, begin by listing detailed duties, responsibilities and expectations. We have included benefit coordinator job description templates that you can modify and use.
Sample responsibilities for this position include:
Research, and resolve client issues, while proactively identify risks and provide proper escalation for high level resolutions
Maintain client-specific training guides for Call Center staff in support of clients’ benefit plan intricacies and for increased call volume during peak seasons
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
Mine data from claims, clinical and other systems
Maintain industry and UHG knowledge in healthcare data, clinical issues, claims coding, data science and Healthplan operations
Investigate claims and other healthcare data using analytical and statistical tools to explain issues, resolve problems, identify outliers, detect anomalies and discover areas for payment integrity attention
Develop case studies and partner with interdisciplinary teams to understand root causes and implement operational and analytic solutions
Collaborate with the data science, data mining, and operational teams on projects to leverage Big Data to advance the triple aim of UHC- better care, better outcomes, and lower cost
Partner with operational teams to understand issues and bring data and analytic solutions to bear
Design, develop, program, maintain and publishing analytic projects and operational reports
Benefit Coordinator Qualifications
Qualifications for a job description may include education, certification, and experience.
Licensing or Certifications for Benefit Coordinator
List any licenses or certifications required by the position: PHR, CP, SHRM, HR, COBRA, FPC
Education for Benefit Coordinator
Typically a job would require a certain level of education.
Employers hiring for the benefit coordinator job most commonly would prefer for their future employee to have a relevant degree such as Bachelor's and Associate Degree in Business, Education, Associates, Public Health, Healthcare, Human Resources, Communications, Management, Business/Administration, Marketing
Skills for Benefit Coordinator
Desired skills for benefit coordinator include:
Excel
HMO environment
Health plan benefits and policies
Kaiser Permanente systems and processes
ACA
COBRA
FMLA
Internet navigation and research
Managed care
Medicaid programs
Desired experience for benefit coordinator includes:
5+ years in Healthcare claims experience
1+ Developing and presenting analytic reports using Tableau or other data visualization tools
Public speaking and presentation skills are essential for all activities
Must be willing to relocate to site of internship
Microsoft office, adobe suites and power point skills are needed for this position
The use of your own personal vehicle is a plus, but not a requirement
Benefit Coordinator Examples
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Benefit Coordinator Job Description
Job Description Example
Our company is looking to fill the role of benefit coordinator. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for benefit coordinator
- Work effectively with internal and external customers including claimants, employers, brokers, account managers, physicians, attorneys, medical care vendors and Unum's underwriting and marketing organizations
- Promote positive customer service and technical expertise through prompt, accurate, and courteous responses to customer information needs
- Contribute to the maintenance of positive customer service through documentation and accountability for resolution of issues identified during direct client contact, as appropriate
- Work individually being a team member
- Participate in professional training cross training activities to enhance performance and skill set
- Independently research, develop, and coordinate complex, high impact solutions/opportunities related to business needs
- Liaison and lead on workgroup and projects that directly impact the implementation team
- Analyze Defined Benefit sale trends and streamline business needs by incorporating high-level initiatives and updates (Salesforce, rewrites, legislative/government changes, internal systems, timelines, service agreements, ERISA Budgets )
- Responsible for the internal administration of outsourced Short Term Disability (STD) adjudication
- May monitor the workflow and make adjustments to ensure the timely completion of program support activities
Qualifications for benefit coordinator
- Experience within a third party benefits administration, health care, health and welfare consulting, insurance brokerage, human resources consulting, or employee benefits related industry is highly preferred
- Proven working experience in compensation and benefits
- Willing to work in late evening hours and interacting with global stakeholders and teams
- Working knowledge of job evaluation and job analysis systems
- Previous experience with organisational psychology and labour market surveys
- Adequate knowledge of current labour rules and regulations
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Benefit Coordinator Job Description
Job Description Example
Our growing company is hiring for a benefit coordinator. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for benefit coordinator
- Assists in monitoring and evaluating program effectiveness
- Administers program procedures and systems
- Assists in the planning, coordination and implementation of seminars, conferences and workshops
- Assists in the preparation of program budgets and grants
- May participate in hiring, performance appraisal, promotions, transfers and other personnel transactions as assigned
- Analyzes community needs to determine program opportunities, scope and goals
- Maintains event calendar
- Coordinates educational programs and outreach activities for associates and/or clients
- Provides education and consultation to leaders and associates on community benefit principles and record-keeping
- Conducts ongoing audits of community benefit records and develops plans for improvements
Qualifications for benefit coordinator
- Demonstrated effective decision making and problem solving abilities
- Familiarity with various types of incentive plans and benefits
- Extensive knowledge of HRIS and MS Office
- 3 years’ experience coordinating and administrating program activities for assigned area
- Minimum of 3 years disability claims processing experience
- Knowledge of, or aptitude to learn, disability claims processes and benefit calculations
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Benefit Coordinator Job Description
Job Description Example
Our growing company is hiring for a benefit coordinator. Please review the list of responsibilities and qualifications. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent.
Responsibilities for benefit coordinator
- Assists with monthly data entry into CBISA software
- Develops written communication tools, including educational tools and reports
- Manages online resource library and regular training announcements
- Assist with coverage research and benefit verification financial qualification analysis
- Primary Responsibility for supporting the establishment of benefit plans in our London, United Kingdom location
- Acts as a primary point of contact for UK based employees on benefit matters, ensuring quick turnaround times and an excellent client experience
- Responsible for completion of job matching exercise and market surveys for our Clinical Development roles in Dublin & London
- Provides support to the HRBPs & People Managers on the Year End Process
- Assists with compensation and benefit system projects including testing for upgrades and new system implementation where required
- Provides support where needed for Compensation & Benefit projects associated with our Raheen, Co
Qualifications for benefit coordinator
- Basic understanding of Medicare regulations
- Keyboard proficient
- Strong persuasion and negotiation skills, and ability to handle conflict on an ongoing basis
- Flexibility and desire to manage multiple tasks simultaneously
- Strong mathematical, analytical, critical thinking, problem solving, and decision making skills, with strong attention to detail
- Strong interpersonal and customer service skills, and the ability to work professionally and effectively with co-workers, clients, claimants and others
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Benefit Coordinator Job Description
Job Description Example
Our company is growing rapidly and is hiring for a benefit coordinator. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for benefit coordinator
- Interacts with all HR functions Accounting, Payroll Treasury and other Finance functions & Legal functions as appropriate
- Performs other duties or projects as assigned by the Human Resource Management Team
- Supports the Global Mobility Team in Expat Payroll Matters
- Responsible for implementation of client discount card plan benefit features
- Conducts quality assurance audits to ensure accuracy of discount card benefit design.Knowledgeable resource for all internal departments and external clients on discount card benefit plan design
- Processing of ID cards from design to print while ensuring accuracy and timely delivery
- Works with outside vendors on client deliverables
- Receives claim assignment, confirms all contractual offsets are coded accurately, benefit schedule is approved into the future and sends acknowledgement of claim and reassignment letter to claimants
- At annual review, analyzes claims including verification that any long term contractual provisions are still being met under the disability plan
- Informs claimants of documentation required to continue to receive ongoing benefits
Qualifications for benefit coordinator
- 3+ years of Disability Claims processing skills
- World @ Work or similar qualification desired
- CIPD qualifications preferred
- Irish & UK Compensation & Benefit required
- Performs job duties under supervision
- Applies judgment and policies to reach solution
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Benefit Coordinator Job Description
Job Description Example
Our company is looking to fill the role of benefit coordinator. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for benefit coordinator
- Denial of claims for failure to provide information or maximum duration reached
- Proactively identifies potential fraudulent activities or trends at the claim level through review of annual update documentation
- Identify unknown contractual offsets through annual review requests, telephone interviews and push reports from vendors
- Makes settlement recommendations decisions promptly
- Meets and exceeds all required operational turnaround times, performance guarantees and quality audits
- Medically managing claims in conjunction with Clinical Resources and Team Manager thereby ensuring compliance with guidelines, procedures, and plan provisions
- This position also works collaboratively with the Legal and Government Relations team, various health system leadership, communications, finance and the Foundation
- The position assists with the development and execution of the Implementation Plan for Community Benefit ensure timeliness of reports, billing and/or program evaluation
- The Community Benefit Coordinator will address customer service issues, schedule, coordinate and attend relevant community and internal meetings and events
- This position will be responsible for tracking and entering community benefit activities into the reporting system via the Community Benefit Inventory for Social Accountability (CBISA) tool, ensures data integrity and information reliability
Qualifications for benefit coordinator
- Good working knowledge of HRIS, preferably Oracle
- Strong organizational abilities (including the ability to handle multiple tasks/projects simultaneously), accuracy and attention to detail are required in this position
- Mathematical - Aptitude with numbers including the ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals
- Previous Pharmacy Benefit Management or Pharmacy experience preferred
- Requires ongoing learning in the pharmacy benefit management industry and continuous product knowledge development in the areas of PBM adjudication software, pharmacology, company specific product offerings, pricing components, and company capabilities and limitations
- Must be able to perform basic math calculations correctly and able to provide service to individuals or situations in a professional manner