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UMWA Health and Retirement Funds · 1 week ago

Benefits Assistant - Eligibility Services

DC-Baltimore Area

Full-time

Onsite

Entry Level

$43K/yr - $66K/yr

2+ years exp

UMWA Health and Retirement Funds is seeking a Benefits Assistant to assist in the benefit application process by validating and entering sensitive data from beneficiary documents. The role involves handling inquiries regarding health and pension benefit eligibility, maintaining electronic funds transfers, and providing general administrative support while collaborating in a team environment.

Financial ServicesHealth CareRetirementWellness

Hiring Manager

Adrian Reeves

Responsibilities

Assists applicants in filling out applications and forms and explains the requirements of accompanying documentation

Compiles and logs all available data and documentation into a complete digital file for processing

Screens applications and supporting documents for completeness and correctness according to specified procedures

Receives a large number of documents; completes an electronic checklist for the case

Analyzes an application to determine whether additional basic information is required

Prepares correspondence to request birth certificates, marriage certificates, and other application processing documentation

Returns incomplete applications for signatures

Calls applicants to confirm application information

Updates checklists with specific documents requested, sets pending codes, and adds processor follow-up dates

Prints and mails correspondence and provides Records Management with copies to scan to the imaged application file

Reviews a mineworker’s complete coal industry employment history when logging new pension application forms

Analyzes signatory credit hours, coal company statements, union dues records, and the applicant’s claimed coal employment history to determine if a wage record should be requested

Completes a wage record request form spanning the appropriate employment period, mails to applicant for signature, and mails the returned document to the Social Security Administration (SSA)

Logs the pension application to reflect the period of claimed coal employment

Adds system comment to document the period earnings were requested and the mailing date

Assigns benefit applications and pension estimate requests to processing staff following the manager’s rotation schedule

Routes imaged documents and applications to assigned processor

Prioritizes the team’s workload to achieve appropriately quick turnaround times

Monitors status of application queue and updates manager if assistance is required to meet established logging turn-around times

Tracks whether requested information and documentation has been received on a timely basis

Manages the follow-up process, using letters and phone calls to make second and subsequent attempts at collecting needed data and documentation

Follows up with SSA and advises manager if wage records are not received within the standard turnaround time

Requests documentation from beneficiaries authorizing the exchange of Medicare eligibility data with the Center for Medicare and Medicaid Services (CMS)

Queries the CMS Medicare database to identify Medicare-eligible beneficiaries

Updates Funds’ eligibility database with CMS enrollment data to enroll appropriate individuals into the Funds’ Health Care Prepayment Plan

Enters, updates and/or corrects beneficiary and payment information and records on computer database systems

Assists in maintenance of records and maintains and compiles statistical data as required

Updates federal tax withholding information and beneficiary addresses

Enters union dues check-off records into eligibility system, maintains records, and responds in writing to dues inquiries from union officials

Meets tight deadlines, especially when beneficiary and payment updates are received close to the cut-off date for creating monthly pension checks

Enters requests for electronic funds transfers (EFT) into automated database and maintains a large database of bank account data for over a large number of payees

Contacts financial institutions to determine appropriate handling of direct deposits or status of checks

Handles all phases of EFT: enters data; researches, and resolves problems; updates the FMS system with the correct information; pre-notes, and identifies payments to be reissued

Compiles, reviews, and mails benefit award letters, including first-payment and stand-alone checks

Matches each beneficiary approval letter against a daily payment register

Follows up with manager if any payment cannot be mailed on the date payment is created

Ensures the secure storage of pension checks following established procedures

Maintains a supply of standard beneficiary mailing inserts and verifies that all required inserts are included with each mailing

Hand delivers all outgoing payments directly to mailroom staff

Reviews General/Durable/Medical Power of Attorney, Guardianship, Conservatorship, and other representative documents for completeness

Enters, documents, and files or routes information in FMS as appropriate

Communicates verbally and in writing with applicants, UMWA representatives, coal company representatives and local, state and federal agencies on routine eligibility matters

Answers basic eligibility and benefits questions, directs inquiries to appropriate staff for more complex issues, and provides general information concerning Funds' application process

Processes returned beneficiary mail and checks

When mail is returned undeliverable, cancels returned checks, maintains detailed records, and follows detailed procedures to secure data and payments

When returned mail indicates that a beneficiary has moved, attempts to locate the beneficiary and requests written confirmation of their new address

Notifies manager if unable to locate beneficiaries so that benefits and payments may be suspended

Monitors, researches, and resolves issues related to non-negotiated checks that have become stale dated

Participates in recurring and nonrecurring special projects such as beneficiary questionnaires, TEFRA notices, 1099s, and 1095s, and Medicare correspondence mailing

Types short letters and memos from handwritten drafts and other records

Responsible for adhering to all Funds’ policies and procedures adopted to comply with the Health Insurance Portability and Accountability Act (HIPAA) governing the privacy, security, and use of protected health information

Travels as required to conduct Funds’ business

Assists with special projects and day-to-day activities

Qualification

FMSData entryTyping (25 wpm)ExcelMathematical skillsOffice equipment operationCommunication

Required

High school diploma or General Education Degree (GED) PLUS two years of prior experience working with a large number of people and/or documents and following complex policies and procedures

Demonstrated ability and willingness to efficiently use FMS or other web-based applications to collect information, generate reports, and manipulate data

Demonstrated ability to operate office equipment including PC's, copier machines, fax machines, printers, and scanners

Must pass speeded typing test at minimum of 25 wpm with 5 or fewer errors

Must demonstrate the ability to communicate effectively by passing an oral test

Basic - Ability to effectively present information in one-on-one and small group situations such as to beneficiaries and other Funds' employees for the purpose of exchanging basic factual information and coordinating activities

Basic - Ability to read and comprehend simple instructions, short correspondence, and manuals

Basic - Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent

Complete background check required