POSITION: |
Benefits Administration Specialist |
COMPANY: |
EmblemHealth |
LOCATION: |
55 Water St.
|
HOURS: |
9am to 5pm Mon - Fri
|
DEPT: |
|
|
Description of Duties |
Posting closing date: 07/31/2009
Essential duties:
Supports the Director of Benefits Compliance with the Q-care Administrative Adjudication Platform. Provides Q-care benefit consultation and support to HIP staff and external entities, particularly as it relates to the development of base plans, service categories and rider codes.
Manages the Benefits Administration process of identifying, developing, creating, modifying and maintaining new base plans, service categories, rider codes and benefit sets in Q-Care.
Manages relationships with down stream business units that rely on the information loaded in Q-Care by Benefits Administration.
Interfaces with IS Department to manage the Benefits Administration responsibilities associated with revisions and updates to the benefits regions of the Q-Care system.
Provides Benefit Administration training and support to internal and external entities.
Responds to Q-care benefit related questions from HIP business units.
Answers benefit-related questions from other HIP Departments.
|
Requirements |
Bachelor’s degree.
Minimum 3-5 years of healthcare/insurance experience, particularly Benefits and HMO/Insurance products.
Knowledge Skills & Abilities:
In depth knowledge and understanding of the Qcare administration system.
Awareness of CPT and ICD9 codes
Thorough understanding of claims adjudication process
Thorough understanding of Emblem Health’s health benefit insurance products
Strong analytical skills
Team player
Flexibility
Multi-tasker
|