Responsibilities and duties
- Work with sales team to collect information needed to request quote.
- Assemble sales packet for sales presentation.
- Work with sales team to collect group plan design information.
- Work with Highmark, Caremark, and Everence to set up plan design; Serve as Caremark Specialist.
- Collect and distribute plan documents, Summary Plan Design and TPA Administrative Agreement.
- Provide support to sales team by collecting claim reporting, creating the renewal memo and assemble renewal packet.
- Ensure all information is received for renewal and collect missing information.
- Create and distribute Reinsurance Notification of Renewal.
- Process enrollments, cancellations and employee changes (as needed or assigned).
- Provide ongoing reporting such as claims and census.
- Distribute TPA Fee Increase Notification.
- Distribute Creditable Coverage Notification.
- Develop and send invoices as needed.
- Primary or backup for reinsurance, HRA and NABCO appointed.
- Stay abreast with regulatory environment, such as Affordable Care Act and Health and Human Services rulings that pertain to self-funded groups and distribute as needed.
- Maintain a working knowledge of MyWave/Broker Briefcase and Navigate.
- Develop and maintain uniform procedures.
- Cross train and back-up other TPA Sales and Service Assistant.
- Complete projects or assignments as directed by manager.
Prior experience in insurance or Human Resources processes/benefits preferred.
Hold license for Life/Health and Accident insurance or ability to obtain within a year.
Skills and Abilities
- Strong organizational skills; takes initiative.
- Excellent attention to detail.
- Ability to keep information confidential.
- Self-directed with a strong sense of urgency.
- Ability to handle multiple tasks and interruptions with efficiency, calmness and courtesy.
- Proven relational and communication skills in working with others; excellent written and verbal communication skills.
- Ability to handle difficult situations with tact and diplomacy; good judgment and problem-solving abilities.
- Ability to work well in a team atmosphere and with other team members.
- Vision-oriented to continually look for improvements in work processes and opportunities for growth.
- Advanced working knowledge of PC-based software including Microsoft Word, Excel, Outlook, Access, and AS400.
Everence Corporate Office- Goshen, IN