CareersEmployee Benefits Specialist

Current Job Openings

Employee Benefits Specialist

Posting Date: 01/07/2019
Closing Date: Until Filled

Reports to: Account Srvices Managr
Exempt

Responsibilities

SUMMARY:                       

Is responsible for providing marketing, education and service to TML MultiState Intergovernmental Employee Benefits Pool (TML MultiState IEBP) Members/potential in developing, maintaining, and monitoring a quality focused, cost efficient delivery of healthcare;

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned:

  • Develop and coordinate cohesive account service team to provide exemplary service.
  • Serves as a technical resource to members and providers for benefits.
  • Provide personalized service including: assisting with benefit plan and policy interpretation and education; facilitating completion of required services coordinating issues/information through Medical Intelligence, B&E, HITECH/Online Enrollment System, Fund Contact, external vendors and other information sources
  • Manage the implementation of new business to ensure coverage is in place and enrollment is completed timely. 
  • Manage the closing of renewal process to ensure that plan changes are implemented and that open enrollment is concluded in a timely manner.
  • Responsible for working with multiple departments to ensure that escalated or complex customer service issues are resolved and communicating closure to member or employer. 
  • Provide member reports and information as requested
  • Responsible for monitoring service support trends and provide management reports that highlight service trends, priorities, focus and respective outcomes.
  • Participate in annual and/or quarterly reviews with underwriting and marketing.
  • Develops and maintains a routine visit/education schedule with current and Potential Members to provide personalized onsite account service and education. Summary of visit activities and resolutions reported in a timely manner.
  • Communicates legislative & regulatory changes to Members effectively
  • Manages relations with Primary Fund Contacts through ongoing consultative services regarding: customer service, product analysis, employee communications, legislative compliance
  • Serves as a technical resource to Members and providers for benefits, claims and other service-related issues in order to improve personalized customer service including: assisting with benefit plan and policy interpretation and education; facilitating completion of required
  • Coordinate with Billing and Eligibility to ensure all required documents are processed timely.
  • Such as signed contracts, Business Acceptance Form, completed enrollment forms, eligibility documents, other coverage forms, etc.
  • Maintains rerate tracking documentation and renewal schedule to assist in renewal process.
  • Fields member calls and questions in regards to rerate forms, new products, and general questions/issues as back up.
  • Reach out to members as needed to obtain missing enrollment information.
  • Maintains accurate SalesForce records regarding broker, potential member, member logs and group contacts by close of each month.
  • Troubleshoots and resolves technical issues with .work, personal, and Online Enrollment accounts for group contacts
  • Protects the confidentiality, integrity and availability of information and records that TML MultiState IEBP creates, receives, maintains or transmits by complying with TML MultiState IEBP policies and procedures, including policies and procedures on physical, administrative and technical safeguards.
    • Physical safeguards are physical measures, policies and procedures that protect TML MultiState IEBP’s buildings, equipment and information systems from natural and environmental hazards and from unauthorized intrusion.
    • Administrative safeguards are administrative actions, policies and procedures that: (1) manage TML MultiState IEBP’s selection, development, implementation and maintenance of measures that protect TML MultiState IEBP’S information and records; and (2) manage the conduct of TML MultiState IEBP employees in protecting the privacy and security of TML MultiState IEBP’s information and records.
    • Technical safeguards are the technology and policies and procedures for its use that protect electronic information and records and that control access to electronic information and records.

 



Qualifications / Skills Required

KNOWLEDGE/SKILLS/ABILITIES:

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, skills, and/or abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • Working knowledge of the following:  healthcare benefits, Life, Continuation of Coverage, Retiree, STD/LTD, Vision, Dental, Flex or external vendor management
  • Working knowledge of Patient Protection Affordable Care Act and COBRA
  • Ability to develop competitive market analysis
  • Marketing experience
  • Collaborative Teamwork
  • Performance Based Solution Performance
  • Ability to compile, analyze and evaluate complex information
  • Strong organization skills, ability to manage multiple priorities and strong follow through
  • Excellent written and interpersonal communication skills
  • Strong customer service skills and attention to detail
  • Ability to meet all sales/service requirements at corresponding range criteria percentile
  • Ability to provide training to Member/provider entities one-on-one or in groups
  • Must be able to work with all levels of employees
  • Working Knowledge of SalesForce or related platform;
  • Working knowledge of MS Office
  • Technical ability to utilize employer web portal and OnBase for claim/provider look-up and CSCL documentation and look-up

EDUCATION/EXPERIENCE:

  • Bachelor's degree from four-year college or university; or five years’ experience in healthcare/benefits/insurance environment; or an equivalent combination of education and experience

PHYSICAL/MENTAL REQUIREMENTS:

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.

  • Ability to speak/hear clearly to communicate by phone or in person
  • Ability to frequently stand, sit and walk
  • Ability to frequently lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds 
  • Ability to travel on a regular basis
  • Valid Texas driver’s license


To Apply
Please submit your resume with a cover letter to Human Resources. Indicate the position you are applying for and detail how you meet the qualifications listed. You may fax this information to (512) 719-6717, email us at Email Us, or mail it to:
TML Health
Attn: Human Resources
P.O. Box 140644
Austin, TX 78714-0644