1199SEIU Benefit and Pension Funds · 2 months ago
Quality Control Reviewer III
New York, NY
Full-time
Onsite
Entry, Mid Level
2+ years exp1199SEIU Benefit and Pension Funds is a dedicated organization providing support for retirees. The Quality Control Reviewer III is responsible for assisting retirees with inquiries about their health and pension benefits, ensuring accurate processing of applications, and troubleshooting complex issues related to retiree benefits.
Non ProfitRetirement
Responsibilities
Greet and assist retirees over the phone and via email; review and validate member demographics against database to measure system accuracy
Assist 1199SEIU retired members with inquiries regarding Retiree Health and Pension Benefit eligibility and payment status
Review and verify submitted Pension applications and forms ensuring all required documentation is provided and complete
Explain application process and assist members with enrollment for the 1199SEIU Medicare Advantage Plan or Medicare Part D; assist members with Aetna MAPD enrollment
Schedule interviews with prospective pensioners; update members with status of pension applications
Communicate with members, via telephone and/or email regarding claims and other benefit related inquiries; provide support to Telephone Representatives as needed
Troubleshoot problems, assist members/retirees in resolving difficult and complex issues related to pension, claims, retiree benefits and payments, answer questions regarding policies, retiree programs and service
Partner with various departments (i.e.: Eligibility, Medical Claims and Pension) to resolve member inquiries
Compose verification letters, generate duplicate 1099R tax forms, explanation of benefits and health identification cards at members’ request; request letters of Creditable Coverage as needed
Access web-based applications relevant to inquiries (i.e.: V3, QNXT, Superscreen, BeneFaqs, Medco, iObserver, DocFind, etc.)
Perform additional duties and projects as assigned by management
Qualification
Required
High School Diploma or GED required; some College or Degree preferred
Minimum two (2) years' experience in a high-volume call center as a Telephone Representative in a health insurance or benefits environment required
Knowledge of 1199SEIU Benefit and Pension Fund eligibility guidelines, benefit entitlements, and plan rules for multiple Funds (Greater NY Benefit Fund, Home Care Employees Pension Fund and National Benefit Fund)
Knowledge of pension operations and systems (Eligibility, Disability, Medical, Pension, etc.) required
Knowledge of call tracking systems, eligibility systems and all web-based applications (i.e: V3, Iris, iObserver and QNXT); basic knowledge of Microsoft Outlook, Excel and Word preferred
Excellent communication skills – oral, written and listening; excellent interpersonal skills including courtesy, tact and discretion
Ability to maintain a professional manner; ability to maintain a pleasant attitude to ensure excellent service to
Able to work well under pressure, multi-task, establish priorities, meet deadlines and follow through on assignments
Able to provide coverage at front windows and/or satellite offices due to operational needs
Call Center hours of operation are from 8:00am – 6:00pm; shifts are subject to change and/or availability
Company
1199SEIU Benefit and Pension Funds
The 1199SEIU Funds are among the strongest and largest labor-management funds in the nation, providing a range of comprehensive benefits to 400,000 working and retired healthcare industry workers — members of 1199SEIU United Healthcare Workers East — and their families.
1001-5000 employees
H1B Sponsorship
1199SEIU Benefit and Pension Funds has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (1)
2022 (1)
Funding
Current Stage
Late StageTotal Funding
$3.72MKey Investors
Community Development Financial Institutions Fund
2023-04-10Grant· $3.72M
Leadership Team
Donna Rey
Executive Director & CEO
Recent News
Crain's New York Business
2023-12-22
Company data provided by crunchbase