Benefits Coordinator

Job Description

Job Description

POSITION SUMMARY

The Benefits Coordinator is supporting all aspects of benefit configuration from programming, reviewing, and auditing benefit configuration to ensuring that all benefits are programmed accurately for Authorizations and Claims.

RESPONSIBILITIES-DUTIES

• Knowledgeable of Health Plan web sites to obtain benefits information for members.
• Able to contact Health Plans by phone to verify members benefits.
• Understand to check Eligibility at the same time while verifying benefits.
• Communicate and document findings internally with Benefits team.
• Ensure all systems are responsible, reliable, responsive and support to the needs of all IPAs of AMM
• Communicates, monitors and audits processes and procedures necessary to achieve strategic objectives.
• Create and Maintain Option Masters for each benefit option provided by the Health Plan by LOB. This module houses the financial responsibility table number, Out of Pocket Maximums and Deductibles
• Develops and implements data integrity initiatives for benefits configuration and any other areas that support the effective operation of internal systems.
• Coordinates, documents, and development projects - Must be highly organized.
• Assists and support different department inquiry with emails, answering phone calls and call health plans to verified information.
• Provides daily oversight of benefits.
• Input and update benefits for all Health plans and all IPAs’ lines of business.
• Responsible for adding options in EzCap for Eligibility Department daily.
• Program, review and update benefits in EzCap on a daily basis
• Assist in downloading Benefits Online
• Assist and recommend in the development of process improvements including policies and procedures
• Assist with training and supporting AMM team.
• Able to respond to emails in a timely manner and provide support
• Coordinating with various departments to resolve benefits inquiries or any system related issues
• Good judgments to plan and accomplish goals
• Performs variety of different tasks
• Administers and ensures timely completion of all projects
• Other duties may be assigned as needed to assist

EDUCATION & EXPERIENCE REQUIREMENTS

AMM BENEFITS

When you join AMM, you’re not just getting a job—you’re getting a benefits package that puts YOU first :