• CAER Representative I

    Job Locations US-IL-Aurora
    Posted Date 3 months ago(10/24/2018 10:10 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 and applying monthly contributions from employees/employers based on the Collective Bargaining Agreement, which is essential in providing participants with eligibility for health care coverage. This also includes processing applications for Consolidated Omnibus Budget Reconciliation Act (COBRA) and processing and applying cash from participants through Self-Pay and/or COBRA.


    Essential Job Functions:



    • Receives imports, balances contribution reports, and applies/adjusts payments
    • Inputs principal liabilities and cash received accurately in system
    • Monitors employer reports and referrs late employers to legal department
    • Maintains, monitors and reviews forms for dependent coverage and related contributions
    • Reviews monthly work history to determine eligibility for coverage
    • Notifies participants of payment discrepancies and cancellations through written correspondence
    • Reviews eligibility rules to determine amounts owed for self-payments
    • Maintains and monitors employee elections and related co-premiums
    • Receives balances and allocates daily cash receipts and the participant/dependent payments. Provides daily balancing reports to the Accounting Department.
    • Ensures that eligibility is updated timely to prevent problems with participants/dependents coverage seeking care
    • Escalates recurring issues that delay eligibility to management
    • Monitors outstanding balances and contacts employers regarding delinquencies
    • Prepares delinquency material and refers outstanding balances to the Legal department
    • Prepares and administers payment plans with employers
    • Provides exceptional customer service
    • Performs other duties as assigned within the scope of responsibilities and requirements of the job
    • Performs Essential Job Functions and Duties with or without reasonable accommodation


    • High School Diploma or GED
    • College coursework preferred
    • 1 ~ 2 years of related experience minimum
    • Working knowledge and experience in Accounting, medical insurance, eligibility billing, delinquency procedures, reconciliation of payments, and collections
    • Preferable experience in eligibility rules including COBRA and Health Insurance Portability and Accountability Act (HIPAA), Employee Retirement Income Security Act (ERISA), and a understanding of Collective Bargaining Agreements


    Skills and Abilities:


    • Intermediate level Microsoft Office skills (PowerPoint, Word, Outlook)
    • Intermediate level Microsoft Excel skills
    • Communication, organizational, analytical, and deductive reasoning
    • Problem solving, multi-tasking and decision making skills
    • Customer service


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