• CAER Representative I

    Job Locations US-IL-Aurora
    Posted Date 3 weeks ago(5/25/2018 10:58 AM)
    # of Openings
  • Overview




    Looking for a way to influence the health and healthcare of many?


    If so, we’d love to hear from you! Our mission-driven organization is focused on theTriple Aim - Better Health, Better Healthcare and Lower Costs to individuals and their families who participate in our health plans.


    UNITE HERE HEALTH serves 100,000+ workers and 220,000 covered lives in the hospitality and gaming industry nationwide. Our desire to be innovative and progressive drives us to develop impactful programs and benefits designed to engage our participants in managing their own health and healthcare. Our vision is exciting and challenging. Please read on to learn more about this great opportunity!



    Key Attributes:


    • Integrity – Must be trustworthy and principled when faced with complex situations
    • Ability to build positive work relationships – Mutual trust and respect will be essential to the collaborative relationships required
    • Communication – Ability to generate concise, compelling, objective and data-driven reports
    • Teamwork – Working well with others is required in the Fund’s collaborative environment
    • Diversity – Must be capable of working in a culturally diverse environment
    • Continuous Learning – Must be open to learning and skill development.  As the Fund’s needs evolve, must be proactive about developing new areas of expertise
    • Lives our values – Must be a role model for the Fund’s BETTER Culture and Mission (Better, Engage, Teamwork, Trust, Empower, Respect)




    This position is responsible for processing enrollments and elections based on the Collective Bargaining Agreement which is essential in providing participants with eligibility for health care coverage. This also includes processing applications for COBRA and processing and applying cash from participants through Self-Pay and/or COBRA.


    Essential Job Functions:

    • Receive, key and balance contribution reports and apply payments
    • Input principal liabilities and cash received on the Aging Receivables report
    • Review pro-activity report for monitoring late fee policy
    • Maintain and monitor and review forms for dependent coverage and related contributions
    • Review dependent work history to determine if participant is eligible for dependent coverage.
    • Process dependent coverage enrollments by notifying participants and employers through written coorespondence.
    • Review participant work history and eligibility to determine amounts owed for self-payments.
    • Maintain and monitor employee elections and related co-payments
    • Notify participants of payment discrrepancies and cancellations through written coorespondence.
    • Receive, balance, and allocate daily cash receipts for the team and the department and provide information to the Accounting Department
    • Ensure that eligibility is updated timely to prevent problems with participants accessing care.
    • Escalate recurring issues that delay participant eligibility to management.
    • Monitor outstanding balances and contact employers regarding delinquencies
    • Prepare delinquency material and refer outstanding balance to the Legal department
    • Prepare and administer payment plans with employers
    • Provide customer service for locals, employers and participants, as well as internal staff
    • Receive, balance and allocate daily participant payments and provide daily deposit information to the Accounting Department.
    • Perform other duties as assigned within the scope of responsibilities and requirements of the job.
    • Perform Essential Job Functions and Duties with or without reasonable accommodation.


    • High School Diploma 
    • Minimum of 2 ~ 3 years of related experience that provides a working knowledge of audit, billing, and delinquency procedures, reconciliation of payments, collections, eligibility rules including COBRA and HIPAA Regulations and customer service
    • Training or education that provides a general understanding of the administration of welfare benefits, audit and billing procedures, Collective Bargaining Agreements, and ERISA, COBRA and HIPAA laws preferred
    • Intermediate Level Microsoft Office skills (PowerPoint, Word, Outlook).


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